26 September 2026
: Case report 
When A Fall Isn’t Just a Fall: Delayed Diagnosis of Acquired Hemophilia A in a Nonagenarian Patient
Mistake in diagnosis, Rare disease
Swati Gobhil BCDEF 1*, Arjun Khunger BCDEF 1, Prajeesh Kandoth Karerat BCDEF 1DOI: 10.12659/AJCR.954126
Am J Case Rep 2026; 27:e954126
Table 1 Coagulation profile of the patient during index admission. It highlights normal PT, prolonged aPTT, reduced factor VIII activity, and increased factor VIII inhibitor levels. D-dimer elevation was felt to be secondary to large soft tissue hemorrhage.
| Test | Result | Reference range |
|---|---|---|
| PT/INR | 10.5 s/1.0 | 9.2–12.2 s/0.9–1.1 |
| Von Willebrand factor antigen | 187% | 50–217% |
| Ristocetin cofactor | 192% | 42–200% |
| Fibrinogen | 415 mg/dL | 200–450 mg/dL |
| Factor IX activity, clotting | 85% | 60–160% |
| Factor IX activity | 200% | 60–150% |
| D-dimer | 5.94 mcg/mL | ≤0.92 mcg/mL |
| PT, prothrombin time; aPTT, activated partial thromboplastin time; INR, international normalized ratio; BU, Bethesda units. | ||