A patient with classic hemophilia (AHF-deficiency) who demonstrated an acquired platelet functional and bleeding time defect concurrently with an AHF inhibitor is described. Possible etiologies for the platelet defect have been proposed and their role in this patient evaluated. Platelet function studies on six other patients with hemophilia A were normal with the exception of defective platelet adhesion to glass in a patient who had been recently transfused.
The combined platelet functional defect and AHF inhibitor found in our patient may be more common than is generally realized. We suggest that any hemophiliac who fails to respond to conventional transfusion therapy should be investigated for both abnormalities.