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Acquired haemophilia heralded by bleeding into the oral mucosa in a patient with bullous pemphigoid, rheumatoid arthritis, and vitiligo

¹ Department of Haemostasis and Thrombosis, Directorate of Haematology, Leicester Royal Infirmary, Leicester, UK
² Department of Dermatology, Leicester Royal Infirmary

Correspondence to:
Correspondence to:
Dr R S Patel
Department of Haemostasis and Thrombosis, Directorate of Haematology, Leicester Royal Infirmary, Leicester LE1 5WW, UK; rakeshspatel{at}hotmail.com

Acquired haemophilia is rare and potentially fatal, with a mortality of 20% if left untreated. There is a strong association with other autoimmune diseases. This report describes a patient with rheumatoid arthritis, vitiligo, and bullous pemphigoid where the diagnosis of acquired haemophilia was made after an extensive bleed into a bullous lesion in the buccal mucosa. This case highlights some of the potential complications of acquired haemophilia and its treatment.

Keywords: acquired haemophilia; bullous pemphigoid; buccal haematoma; factor VIII inhibitor concentration; factor eight inhibitor bypassing activity (FEIBA)