Acquired factor VIII inhibitor in a nonhemophilia patient on hemodialysis: challenges in management.

It is well known that the uremic milieu predisposes patients to an increased risk of bleeding. We report a case of a patient on hemodialysis who developed recurrent unexplained bleeding episodes. His renal failure was secondary to systemic lupus erythematosus. Further investigations revealed that his bleeding was secondary to the development of acquired inhibitors to factor VIII: C following a flare up of his systemic lupus erythematosus. Management issues related to recurrent bleeding in this situation are discussed and reviewed.