PB1026 - Acquired hemophilia (AH) in Mexico: A nation-wide study

Background: AH is a rare but devastating hemorrhagic disorder affects both genders and is associated with several pathological states

Aims: Our aim was to, prospectively, diagnose and analyze the clinical characteristics of cases with AH in Mexico

Methods: Since January 1st, 2021 up to December 31st, 2023, 218 samples were referred to our center in order to look for or confirm cases with a high clinical suspicion of AH. Plasma samples were sent to Mexico City from 19 out of 31 states encompassing the Mexican Republic. Plasmas were packed under freezing conditions (-60 °C) using dry ice and sent in no more than 24 h after obtained. Samples were immediately processed at arrival.

Results: During the study period, 208 samples were sent but results compatible with AH diagnosis was made in only 121 patients. They were 79 women 42 men with a median age of 62.5 years-old (ranges: 28-81) (Table 1). In 114 (94.2%) of the patients, the diagnosis was suspected due to a clear hemorrhagic presentation; in the remaining patients, the diagnosis was suspected because abnormal blood coagulation tests. Diagnosis was suspected by a hematologist in 116 (95.9%). Relapses have been recorded in only two patients with autoimmune diseases. Table 1 shows clinical characteristics of the patients at diagnosis as well as main laboratory data. The presence of lupus inhibitor was always ruled-out. Table 2 shows data regarding treatment. Eight deaths were recorded, all them associated to bleeding complications; three were associated with onco-hematological disease, two with autoimmune diseases, and three occurred in patients with no comorbidities associated

Conclusion(s): AH is a rare yet underdiagnosed clinical entity in Mexico. As described elsewhere, it is a potentially lethal disease with a wide spectrum of primary disease associations, clinical presentations, and response to treatments. Besides major differences in treatments used, the mortality rate was relatively low