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Background: Osteonecrosis of the femoral head is a common orthopedic disease, usually caused by traumatic and non-traumatic factors. Antiphospholipid syndrome (APS) is an autoimmune disorder marked by the persistent presence of antiphospholipid antibodies (aPL). Acquired subclinical hemophilia A is a subset of acquired hemophilia A. The content of factor VIII often drops to the subclinical range due to the inhibitor of factor VIII produced by certain autoimmune diseases. Here, we report a rare case of osteonecrosis of the femoral head with APS and subclinical hemophilia A.
Methods: The patient was diagnosed with bilateral femoral head necrosis according to clinical symptoms and imaging findings. APS and subclinical hemophilia A were diagnosed based on a coagulation function test, APTT correction experiment, antiphospholipid antibody detection, thromboelastogram and coagulation factor activity and inhibitor detection.
Results: The above test results confirmed the presence of both antiphospholipid antibodies and factor inhibitors in the patient, which is rare clinically. The diagnosis of femoral head necrosis with antiphospholipid syndrome and acquired subclinical hemophilia A was established.
Conclusions: Such cases are extremely rare, relevant experimental results are complex, and misdiagnosis and mistreatment are common clinically. We report this case to remind clinicians and blood transfusion department staff to focus on coagulation experiments and related diseases, avoid misdiagnosis and delayed diagnosis, and provide timely, standardized treatment to improve patient prognosis.
DOI: 10.7754/Clin.Lab.2025.250342
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