Acquired haemophilia is a rare but life-threatening bleeding disease that c
an be observed in males or females at various ages. In the present study, w
e report on five cases of acquired factor (F) VIII inhibitors diagnosed in
the elderly population over a period of 5 years between 1995 and 1999 in ou
r hospital. The median age of the patients at the time of diagnosis was 76.
2 years (66-92 years). In all cases, the diagnosis was suggested by mild to
severe bleeding with no previous bleeding history. While the absence of as
sociated conditions is frequently reported especially among the elderly, in
our series an underlying disease was found in four out of the five cases:
kidney tumour (two cases) and autoimmune disease (two cases). The bleeding
was controlled in four patients using porcine FVIII (two cases) or recombin
ant FVIIa (two cases). The inhibitors were completely resolved in two patie
nts (kidney tumour, GoodPasture syndrome) by treatment of the underlying di
sease. However, three patients died as direct or indirect consequence of ha
ving an inhibitor. Our series confirms and extends previous data reporting
the complexity and severity of this disorder. Because bleeding is often sev
ere, a prompt and correct diagnosis is required to provide adequate therape
utic options that take the advanced age of the patients into account.