{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:29:38Z","timestamp":1786969778305,"version":"build-2736575974"},"reference-count":11,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,6]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Acquired haemophilia A (AHA) is a rare autoimmune bleeding disorder caused by neutralising antibodies against factor VIII. We describe an older man with prostate cancer on active surveillance who presented with spontaneous ecchymoses, progressive anaemia and isolated prolongation of activated partial thromboplastin time. Factor VIII activity was severely reduced, and mixing studies and Bethesda assay confirmed a high-titre factor VIII inhibitor. He achieved initial haemostatic control with recombinant-activated factor VII and was transitioned to emicizumab using an accelerated AHA regimen. No corticosteroids were given inpatient. Emicizumab was used for haemostatic prophylaxis while outpatient once-weekly rituximab was planned for inhibitor eradication. This case highlights early recognition, evaluation for associated malignancy and use of emicizumab as prophylaxis that may allow individualised immunosuppression in selected older patients.<\/jats:p>","DOI":"10.1136\/bcr-2026-274804","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:20:23Z","timestamp":1786969223000},"page":"e274804","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Acquired haemophilia A associated with prostate cancer managed with recombinant activated factor VII and emicizumab"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3771-9877","authenticated-orcid":false,"given":"Baqir Hasan","family":"Jafry","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew I","family":"Hearn","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"2026081705200970000_19.8.e274804.1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.230771"},{"key":"2026081705200970000_19.8.e274804.2","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/S0022-5347(17)50864-2","article-title":"Spontaneously acquired anti-factor VIII antibodies: report of a patient with adenocarcinoma of the prostate","volume":"131","author":"Preminger","year":"1984","journal-title":"J Urol"},{"key":"2026081705200970000_19.8.e274804.3","first-page":"172","article-title":"Acquired factor VIII inhibitor associated with prostatic cancer: successful treatment with steroid and immunosuppressive therapy","volume":"15","author":"Moccia","year":"2000","journal-title":"Ann Ital Med Int"},{"key":"2026081705200970000_19.8.e274804.4","doi-asserted-by":"crossref","first-page":"255","DOI":"10.2147\/JBM.S284804","article-title":"Acquired Hemophilia A: Current Guidance and Experience from Clinical Practice","volume":"13","author":"Pishko","year":"2022","journal-title":"J Blood Med"},{"key":"2026081705200970000_19.8.e274804.5","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1055\/a-2384-3585","article-title":"Final Analysis Results from the AGEHA Study: Emicizumab Prophylaxis for Acquired Hemophilia A with or without Immunosuppressive Therapy","volume":"125","author":"Shima","year":"2025","journal-title":"Thromb Haemost"},{"key":"2026081705200970000_19.8.e274804.6","doi-asserted-by":"crossref","first-page":"e913","DOI":"10.1016\/S2352-3026(23)00280-6","article-title":"Emicizumab prophylaxis in patients with acquired haemophilia A (GTH-AHA-EMI): an open-label, single-arm, multicentre, phase 2 study","volume":"10","author":"Tiede","year":"2023","journal-title":"Lancet Haematol"},{"key":"2026081705200970000_19.8.e274804.7","doi-asserted-by":"crossref","first-page":"32461","DOI":"10.3402\/jchimp.v6.32461","article-title":"Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer","volume":"6","author":"Sheth","year":"2016","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"2026081705200970000_19.8.e274804.8","doi-asserted-by":"crossref","DOI":"10.1177\/2050313X20906743","article-title":"Acquired factor VIII deficiency in prostate adenocarcinoma presenting as multiple hematomas and hemarthrosis","volume":"8","author":"Lewis","year":"2020","journal-title":"SAGE Open Med Case Rep"},{"key":"2026081705200970000_19.8.e274804.9","doi-asserted-by":"crossref","first-page":"E519","DOI":"10.5489\/cuaj.7089","article-title":"Case - Acquired hemophilia A in a patient with metastatic castration-resistant prostate cancer","volume":"15","author":"Poscente","year":"2021","journal-title":"Can Urol Assoc J"},{"key":"2026081705200970000_19.8.e274804.10","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2016-216890","article-title":"Aspirin unmasking acquired haemophilia A in a patient with prostate cancer","volume":"2016","author":"Okiro","year":"2016","journal-title":"BMJ Case Rep"},{"key":"2026081705200970000_19.8.e274804.11","unstructured":"National Bleeding Disorders Foundation Medical and Scientific Advisory Council . MASAC document 292: national bleeding disorder clinical practice recommendations on the off-label use of emicizumab for the treatment of acquired hemophilia A. 2024."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-274804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:20:25Z","timestamp":1786969225000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-274804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":11,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,17]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-274804"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-274804","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}