Diagnostic Dilemma|Articles in Press

Above the Threshold Time of Coagulation: Delayed Diagnosis of Acquired Hemophilia A

Published:February 23, 2023DOI:
      A man in his 80s presented to our hospital's emergency department with left hip pain after falling while transferring from a wheelchair on a visit day. He had been taking clopidogrel for >10 years after atherothrombotic stroke and apixaban 2.5 mg twice a day for 2 years since he was diagnosed with deep vein thrombosis. The patient had no coagulation abnormalities when he started apixaban therapy and had never experienced bleeding events. His medical history included cervical spondylosis surgery, right femoral neck fracture, hypertension, and benign prostatic hypertrophy. Other medications included candesartan, amlodipine, enalapril, tamsulosin, and tadalafil. He denied any overdose of prescribed medications. The patient had no family history of bleeding disorders. He was a nonsmoker and did not drink alcohol.
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