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Acquired hemophilia is a rare condition that is a disease of the immune system. With this condition, the bodys immune system targets clotting factors in the blood, such as factor VIII. Acquired hemophilia can occur in people that have rheumatoid arthritis and can have serious consequences.

Hemophilia is a disorder that stops the blood from clotting properly. For most people with the condition, it is an inherited disease. Reduced levels of certain blood clotting factors can cause bleeding and trigger serious health problems in some severe cases. There are two types of hemophilia: A and B. Both can be congenital, which means a person inherits it, or they can acquire it, meaning it develops later in life.

Rheumatoid arthritis is an autoimmune disease that mainly affects the joints. The bodys immune defenses mistakenly attack the joints in the hand, wrist, or knee, causing inflammation and damage. Besides chronic joint pain, balance problems, and deformed bones, the condition can also affect organs such as the lungs, heart, and eyes.

A link between both conditions exists. Acquired hemophilia has associations with rheumatoid arthritis in about 48% of cases, and people tend to have a poorer prognosis.

Keep reading to learn more about the link between hemophilia and rheumatoid arthritis, including diagnosing and treating both conditions.

Acquired hemophilia is similar to congenital hemophilia in that it can cause bleeding. However, the acquired form of the disease is a rare immune system disorder that involves the immune system attacking healthy cells.

Unlike congenital hemophilia, acquired hemophilia does not pass down through generations of a family. Additionally, congenital hemophilia only affects males, whereas acquired hemophilia can affect people of any sex.

In acquired hemophilia, the body makes antibodies that attack proteins, known as clotting factors. With these proteins depleted, the blood does not clot as it should. An example of an affected clotting factor is factor VIII. When blood clots, it clumps together at the site of a wound like a plug.

People who have acquired hemophilia can experience a range of serious complications of the disease due to atypical and uncontrolled bleeding into the soft tissue, skin, and muscles. Sometimes this happens spontaneously or due to surgery or trauma.

According to a recent case report, acquired hemophilia can have links to cancer, pregnancy, certain medications, or autoimmune conditions, including:

However, half of all cases of acquired hemophilia have no identifiable cause.

Both acquired hemophilia and rheumatoid arthritis are immune disorders, where the body attacks its own healthy cells.

Many people with a diagnosis of one autoimmune condition go on to develop other autoimmune disorders. Researchers working on a 2022 study found that people with rheumatoid arthritis often have polyautoimmunity.

Polyautoimmunity refers to the state in which a person has more than one autoimmune disease.

Symptoms can occur when the blood is not clotting properly. People with acquired hemophilia might experience the following:

According to a 2022 case report, a 69-year-old female, who had lived with rheumatoid arthritis for 25 years, experienced a severe nosebleed and bleeding into her muscles and skin. When doctors performed tests, they found that she had factor VIII clotting factors below healthy levels in her blood.

An older case report from 2016 involved another 69-year-old woman who required hospitalization. Doctors diagnosed her with rheumatoid arthritis 6 years before. Four months before the hospital admission, she experienced:

Doctors can diagnose both conditions by assessing their symptoms and results from the laboratory.

Doctors may diagnose acquired hemophilia if a person is experiencing atypical bleeding that has only started recently. They use a variety of specialized blood tests that measure how long it takes the persons blood to clot. Some tests might include:

People who are most susceptible to acquired hemophilia include the elderly and those who are about to or have recently given birth.

People with rheumatoid arthritis have swollen and tender small joints. Symptoms can include:

Diagnosing this condition involves reviewing the above symptoms, carrying out a physical examination, taking X-rays, and doing lab tests.

Learn more about how doctors diagnose rheumatoid arthritis.

The main goals of managing acquired hemophilia disease are:

As acquired hemophilia is rare, developing most therapies involves using anecdotal or small case reports. Treatments are highly specialized and depend on many factors, including age, overall health, tolerance for certain medications, and the underlying cause.

Some medications include:

When a persons acquired hemophilia has links to another autoimmune condition, such as rheumatoid arthritis, doctors most commonly write a combined prescription for methylprednisolone and cyclophosphamide. Both medications help prevent the overactive immune system from attacking healthy cells.

Research from 2018 shows that acquired hemophilia is a life threatening condition, and 515% of people with the disease die.

When doctors diagnose a person with acquired hemophilia early and take action to treat the condition sooner, a persons outlook can be more positive. However, some healthcare professionals can miss or misdiagnose the condition.

Additionally, treatment options come with risks. Therefore, people with acquired hemophilia need regular monitoring from their doctors.

Hemophilia may be congenital or acquired. People with acquired hemophilia can have other autoimmune conditions, such as rheumatoid arthritis, at the same time.

Many laboratory tests can help diagnose and treat this condition. Doctors prescribe medications to people with the following goals: controlling bleeding, eradicating the inhibitor, and treating the underlying disease where possible.

The sooner doctors diagnose and treat a person with acquired hemophilia secondary to rheumatoid arthritis, the better their chances of survival.

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What is the link between hemophilia and rheumatoid arthritis? - Medical News Today

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