Renal hemorrhage caused by acquired inhibitors to coagulation factors VIII and V in a hemodialysis patient.

Acquired coagulation factor deficiency is a rare bleeding disorder caused by the inhibitors to coagulation factors. We report a case of an elderly hemodialysis patient who presented with the intermittent hematuria and anemia, associated with the prolonged activated partial thromboplastin time and prothrombin time. Laboratory examination revealed undetectable factor VIII activity, decreased factor V activity, and the presence of inhibitors to these coagulation factors. The patient was diagnosed to have inhibitors to coagulation factors VIII and V simultaneously. In addition, hematuria was found to be caused by the right renal hemorrhage. Renal extravasation was treated by transcatheter arterial embolization. Oral prednisolone successfully eradicated the inhibitors. The present case highlights the importance to consider acquired coagulation factor inhibitors for bleeding symptoms, because they are sometimes life-threatening.