{
  "abstract": "Acquired hemophilia A is a rare autoimmune bleeding disorder caused by the development of autoantibodies against coagulation factor VIII. It is frequently associated with the postpartum period and may present as severe and persistent bleeding in patients without a prior history of coagulopathy, often leading to diagnostic delay. We report the case of a 26-year-old woman in the postpartum period following cesarean section for severe preeclampsia, who developed refractory hemorrhage despite multiple surgical interventions, including exploratory laparotomies, hematoma drainage, and abdominal packing. Laboratory evaluation revealed an isolated prolongation of activated partial thromboplastin time. Mixing studies showed incomplete correction, raising suspicion of a circulating inhibitor. Further testing confirmed severely reduced factor VIII activity and the presence of a factor VIII inhibitor. Serial thromboelastography demonstrated profound hypocoagulability with impaired thrombin generation and episodes of hyperfibrinolysis. The patient was treated with bypassing agents and combined immunosuppressive therapy, resulting in progressive reduction of inhibitor levels and recovery of factor VIII activity, ultimately achieving complete hematologic remission. This case highlights the diagnostic challenges of acquired hemophilia A in the postpartum setting and emphasizes the importance of early recognition of isolated coagulation abnormalities. Prompt diagnosis and a coordinated multidisciplinary approach are essential for effective bleeding control and inhibitor eradication in critically ill patients.",
  "abstract_shown": true,
  "affiliations": [
    "Critical Care Medicine, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, MEX.",
    "Internal Medicine, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, MEX.",
    "Intensive Care Medicine, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, MEX.",
    "Hematology, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, MEX."
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Maria Alaciel Galvan Merlos"
    },
    {
      "affs": [
        2,
        1
      ],
      "name": "Maria Dioselina Ruiz Barrera"
    },
    {
      "affs": [
        3
      ],
      "name": "Cristina Elizabeth Madera Maldonado"
    },
    {
      "affs": [
        0
      ],
      "name": "Liliana Ponce Baños"
    },
    {
      "affs": [
        0
      ],
      "name": "Jorge Omar Castro Meza"
    },
    {
      "affs": [
        2
      ],
      "name": "Lourdes Bautista Martinez"
    },
    {
      "affs": [
        0
      ],
      "name": "Leticia Guerrero Navarrete"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f2bxn1b9fg4h3.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117012",
  "fulltext_url": "https://europepmc.org/articles/PMC13712644",
  "id": "f2bxn1b9fg4h3",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948504",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Hematology"
    ],
    [
      "heading",
      "Internal Medicine"
    ],
    [
      "heading",
      "Therapeutics"
    ],
    [
      "openalex",
      "2720|Hemophilia Treatment and Research"
    ]
  ],
  "openalex": "W7214532611",
  "pdf_url": "https://europepmc.org/articles/PMC13712644?pdf=render",
  "pmcid": "PMC13712644",
  "pmid": "42948504",
  "published": "2026-09-27",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/f2bxn1b9fg4h3.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:35Z",
      "native_id": "MED:42948504",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948504"
    },
    {
      "first_seen": "2026-10-31T12:23:11Z",
      "native_id": "PMC13712644",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117012"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Hemophilia Treatment and Research",
      "subfield": "general"
    }
  ],
  "title": "Refractory Obstetric Hemorrhage As the Initial Presentation of Acquired Hemophilia: A Case Report on the Diagnostic Limitations of Viscoelastic Testing.",
  "title_text": "Refractory Obstetric Hemorrhage As the Initial Presentation of Acquired Hemophilia: A Case Report on the Diagnostic Limitations of Viscoelastic Testing.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:23:11Z",
  "url": "https://research.draconitic.com/paper/f2bxn1b9fg4h3",
  "venue": "Cureus",
  "versions": []
}