{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:10:01Z","timestamp":1756375801941,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,3,21]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Acquired factor VIII inhibitor, also known as acquired haemophilia A, has been associated with the postpartum state in young females. Treatment of acquired haemophilia A is focused on two goals: control of bleeding and eliminating the factor VIII inhibitor. Management requires successful intervention to accomplish both goals. Here, we describe the presentation and management of a case of acquired haemophilia A resulting in particularly severe and protracted intra-abdominal bleeding after routine laparoscopic cholecystectomy in a young and otherwise healthy female at 3 months postpartum. Due to diffuse intra-abdominal bleeding, she required return to the operating room on five occasions for intra-abdominal packing, reassessment of bleeding and ultimate fascial closure. Her abdomen was open for 5\u2009days. She was treated with activated recombinant human factor VIIa to bypass inhibited factor VIII, and with immunosuppression using steroids, cyclophosphamide and anti-CD20 monoclonal antibody rituximab. She achieved remission after 6 weeks of treatment.<\/jats:p>","DOI":"10.1136\/bcr-2023-258812","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T08:35:33Z","timestamp":1711701333000},"page":"e258812","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Severe case of postpartum-acquired haemophilia A after laparoscopic cholecystectomy"],"prefix":"10.1136","volume":"17","author":[{"given":"John Cord","family":"Helmken","sequence":"first","affiliation":[{"name":"Department of Surgery, Prisma Health Upstate, Greenville, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A","family":"Camunas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Prisma Health Upstate, Greenville, South Carolina, USA"},{"name":"University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,3,29]]},"reference":[{"key":"2025082802564089000_17.3.e258812.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04731.x"},{"key":"2025082802564089000_17.3.e258812.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04162.x"},{"key":"2025082802564089000_17.3.e258812.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2012.04654.x"},{"key":"2025082802564089000_17.3.e258812.4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1055\/s-0038-1650169","article-title":"A survey of 215 non-Hemophilic patients with inhibitors to factor VIII","volume":"45","author":"Green","year":"1981","journal-title":"Thromb 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