Adalimumab-associated Acquired Hemophilia in a Patient with Scleritis

ABSTRACT

Acquired hemophilia A (AHA) is a rare condition that may be drug-induced. In this case report, we describe a patient who presented with extensive subcutaneous bleeding three years after beginning treatment with adalimumab for necrotizing scleritis. His workup was compatible with drug-induced AHA. He was treated with high-dose corticosteroids, cyclophosphamide, and rituximab. Adalimumab was discontinued. We present this case as an example of a rare, but potentially life-threatening, complication of adalimumab.

KEYWORDS:

• Acquired hemophilia
• factor VIII inhibitor
• blood coagulation disorders
• adalimumab
• anti-TNF-α
• scleritis

Acknowledgments

Dr. Liberman received funding for her fellowship from the Pan-American Ophthalmological Foundation (PAOF); Retina Research Foundation (RRF); Pontificia Universidad Católica de Chile; National Agency for Research and Development (ANID)/Scholarship Program/BECAS DE SUBESPECIALIDADES MEDICAS EN EL EXTRANJERO/2018 – 76190011.

Declaration of interest statement

The authors report no conflicts of interest.