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A Possible Case of Acquired Hemophilia Following COVID−19 Vaccination

Abstract

Kanak Parmar, Shivam Singh, Robert Horn and Udit Verma

COVID-19 vaccination has been very efficient in preventing severe illness and death from SARS CoV-2. These vaccines are usually reported to have mild and transient side effects. We report a case of a 59-year-old woman with an acquired hemophilia A following the administration of her second dose of mRNA 1273 vaccine. The patient presented with worsening swelling and bruising of her left arm three days after vaccination. She had a history of COVID-19 infection 3 months ago. Laboratory workup showed elevated partial thromboplastin time (PTT) and mixing study showed possible inhibitor. Factor VIII level (%) was <5% and the inhibitor panel confirmed presence of inhibitor. The patient was treated with high dose steroids and cyclophosphamide. Currently the patient is on slow taper steroids and hematoma has improved.

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