DOI: https://doi.org/10.36347/sasjm.2026.v12i09.021

Pages: 936-940

Objective: To describe the clinical, biological, therapeutic, and outcome characteristics of patients with acquired hemophilia A (AHA) managed in a Department of Internal Medicine and Onco-Hematology, and to highlight the challenges associated with severe and refractory cases. Methods: We conducted a retrospective descriptive study of patients diagnosed with AHA and managed in the Department of Internal Medicine and Onco-Hematology between January 2017 and December 2025. Clinical, biological, therapeutic, and outcome data were collected from medical records and analyzed descriptively. Results: Five patients were included, comprising four women and one man, with a median age of 34 years (range: 27–58 years). Two cases occurred in the postpartum period. Deep soft-tissue and intramuscular hematomas were the most common presenting manifestations, including iliopsoas hematomas in two patients. All patients exhibited isolated prolongation of activated partial thromboplastin time, reduced factor VIII (FVIII) activity, and detectable FVIII inhibitors. FVIII activity was below 1% in four patients. High-dose corticosteroids were administered as first-line therapy in all cases. Additional immunosuppressive treatments included azathioprine, cyclophosphamide, and rituximab. Hemostatic agents, including recombinant activated factor VII and activated prothrombin complex concentrate, were used in severe bleeding episodes. During follow-up, three patients achieved sustained remission. One patient experienced relapse associated with a high inhibitor titer (768 Bethesda Units), while another developed persistent neurological sequelae secondary to a compressive hematoma. Conclusion: Acquired hemophilia A remains a rare but serious hemorrhagic disorder with heterogeneous clinical presentations. Early recognition, prompt hemostatic management, and timely immunosuppressive therapy are essential to improve outcomes. Our findings highlight the clinical diversity of AHA and emphasize the imp