Clinical Case Database / Category: Patient Management

The investigation of a bleeding patient

Publication details

Dr Asha Aggarwal, Dr Asif Khan
Foundation Years Journal, volume 9, issue 3, p.43 (123Doc Education, London, March 2015)


A case of sudden onset bruising which demonstrates the approach to a general medical patient with bruising or bleeding. This article outlines the key investigations and their interpretation, followed by the management of acquired haemophilia A.

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Dr Asha Aggarwal

Foundation Year Doctors, Royal Berkshire NHS
Foundation Trust, London Road, Reading, RG1 5AN

Dr Asif Khan (Corresponding author)

Consultant Haematologist, Royal Berkshire NHS
Foundation Trust, London Road, Reading, RG1 5AN


W Collins, P., Chalmers, E., Hart, D et al (2013), Diagnosis and management of acquired coagulation inhibitors: a guideline from UKHCDO. British Journal of Haematology, 162: 758–773. doi: 10.1111/bjh.12463.
2. Collins, P.W., Hirsch, S., Baglin, T.P et al (2007) Acquired haemophilia A in the UK: a two year national surveillance study by UK Haemophilia Centre Doctors' Organisation. Blood, 109, 1870–1877.
3. Knoebl, P., Marco, P., Baudo, F et al (2012) Demographics and clinical data in acquired hemophilia A: results of the European Acquired Heamophilia (EACH2) registry. Journal of Thrombosis and Haemostasis, 10, 622–631.
4. Baudo, F., Collins, P.W., Huth-Kuhne, A et al. (2012) Management of bleeding in acquired hemophilia A: results of the European Acquired Haemophilia (EACH2) registry. Blood, 120, 39–46.
5. Holmstrom, M., Tran, H.T. & Holme, P.A. (2012) Combined treatment with APCC (FEIBA) and tranexamic acid in patients with haemophilia A with inhibitors and in patients with acquired haemophilia A – a two-centre experience. Haemophilia, 18, 544–549.
6. Bitting, R.L., Bent, S., Li, Y. & Kohlwes, J. (2009) The prognosis and treatment of acquired hemophilia: a systematic review and meta-analysis. Blood Coagulation & Fibrinolysis, 20, 517–523.
7. Collins, P.W., Baudo, F., Knoebl, P et al. (2012) Immunosuppression for acquired hemophilia A: results of the European Acquired Haemophilia (EACH) registry. Blood, 120, 47–55.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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