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Age and Ageing, Vol 29, 261-263, Copyright © 2000 by British Geriatrics Society

ARTICLES

Case report. An unusual cause of bruising in an 80-year-old woman

J Kelly, M Gattens and R Geraghty
Department of Medicine for the Elderly, Queen Mary's Hospital, Sidcup, Kent DA14 6LT, UK; Guy's and St Thomas' Hospital, London, UK; Corresponding author; Fax: (+44) 1932 867811

Presentation. A previously fit 80-year-old woman presented with a 2-week history of spontaneous and extensive bruising affecting all four limbs. The severity was such that she required a transfusion of 8 units of blood.Results of investigations. A markedly prolonged activated partial thromboplastin time which was only partially corrected with normal plasma; tests for lupus anticoagulant were negative. Factor VIII levels were reduced and the Bethesda assay indicated an acquired inhibitor to factor VIII. She was treated with a combination of intravenous immunoglobulin and immunosupression.Outcome. The response to treatment was excellent, with a marked reduction in anti-factor VIII antibody levels and resolution of the bruising over the next few weeks.Keywords: acquired haemophilia, factor VIII inhibitor, spontaneous bruising
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