A case of acquired hemophilia A presenting with repeated hemorrhagic esophagitis

An 80-year-old man presented emergently with acute melena and hematemesis. Blood tests revealed anemia, with prolonged activated partial thromboplastin time and normal prothrombin time. Esophagogastroduodenoscopy showed severe esophagitis with hemorrhage ; and he required 10 units of blood transfusion. The intractable esophagitis improved gradually with acid suppression medication. However, 21 days after discharge, he developed a subcutaneous hematoma in his neck. This led to a diagnosis of acquired hemophilia A. We think that the patient had developed acquired hemophilia A during the first admission. Here we report this rare case of repeated hemorrhagic esophagitis caused by acquired hemophilia A.