Acquired hemophilia A presenting as spontaneous hemorrhage following corpus luteum cyst rupture: a case report and review of the literature

: Corpus luteum cyst rupture is a common cause of spontaneous hemoperitoneum discovered within the emergency department (ED) setting. It is extremely uncommon, however, to discover a rare underlying hematologic disorder such as acquired hemophilia in these cases. Early recognition of the condition is essential given the substantial risk of severe morbidity and mortality associated with increased time to diagnosis. We report a case of a 25-year-old female who presented to the ED with lower abdominal pain and a syncopal event, who was found to have spontaneous hemoperitoneum due to a ruptured corpus luteum cyst and was subsequently discovered to have acquired hemophilia A (AHA). Patients with AHA can present to the ED with a wide spectrum of symptoms, most commonly related to the inciting bleeding event. AHA should be considered in all patients who present with profound and prolonged bleeding episodes devoid of immediately identifiable causes within the emergency setting. A high index of suspicion for this condition is critical because surgical intervention in the absence of appropriate hemostatic and immunosuppressive treatment can result in catastrophic consequences.