An unusual case of acute postpartum bleeding in a mother and her newborn

Abstract Acquired haemophilia A (AHA) is a rare autoimmune disease caused by IgG1-4 autoantibodies directed against coagulation factor VIII (FVIII), which causes the sudden onset of severe bleeding in patients with negative family and personal histories. Here, we describe the unusual case of a mother who developed AHA postpartum and had major bleeding. The patient showed isolated aPTT elongation (max. 75 s), a decreased activity of FVIII (min. 2,3%), and the presence of inhibitors [max 1.823 Bethesda Unit (BE)]. On the 14th day of life, her newborn showed several episodes of rectal bleeding without abdominal pain. It was thought that the cause of the bleeding was the same as his mother, so coagulation tests were done, and the results were normal. For feeding, a typical cow’s milk was not used because of protein intolerance. Instead, oral feeding with hydrolysed milk was started, which offered prompt resolution of symptoms.