Acquired hemophilia A mimicking trauma-induced coagulopathy in a young polytrauma patient

Traum a-induced coagulopathy (TIC) occurs in approximately 25% of severely injured patients and is characterized by tissue injury, shock, and endothelial dysfunction. Laboratory diagnosis typically shows abnormalities in the prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen level, and platelets (PLTs).[1] However, a marked isolated prolongation of aPTT in a trauma setting should prompt the consideration of alternative etiologies, such as acquired hemophilia A (AHA). AHA is a rare autoimmune disorder involving autoantibodies against factor VIII ( FVIII). Recognizing AHA is critical, as it requires bypassing agents and immunosuppression rather than standard trauma resuscitation.[2,3]