D68.311
Acquired hemophilia
Clinical Classification Guidelines
Inclusion Terms
- Autoimmune hemophilia
- Autoimmune inhibitors to clotting factors
- Secondary hemophilia
Medical Intelligence & Overview
Acquired hemophilia is an uncommon bleeding disorder characterized by the development of autoantibodies that attack the body's own clotting factors, primarily factor VIII. Unlike inherited hemophilia, this condition is not present at birth but develops later in life. It is often associated with autoimmune diseases, certain medications, or other underlying health conditions. When these autoantibodies interfere with blood clotting, individuals experience unusual and often severe bleeding episodes, which can be life-threatening if not diagnosed and treated promptly.
Causes & Symptoms
Clinical Causes: Autoimmune reactions where the immune system mistakenly attacks clotting factors Underlying autoimmune diseases such as rheumatoid arthritis or lupus Certain medications that may trigger immune responses Cancer-related conditions or malignancies Postpartum period, particularly in women who have recently given birth Other health conditions that compromise the immune system Idiopathic cases where no specific cause is identified
Key Symptoms: Unexplained bleeding episodes Bleeding into the skin causing bruising or hematomas Bleeding from mucous membranes such as the nose or gums Blood in urine or stool Excessive bleeding after injuries or surgeries Bleeding into muscles or joints in severe cases In some instances, bleeding may be sudden and severe, requiring immediate medical attention
Diagnostic & Treatment
Diagnosis Path: Blood tests revealing a prolonged activated partial thromboplastin time (aPTT) that does not correct with mixing studies, suggesting the presence of inhibitors Specific assays to detect and quantify autoantibodies against clotting factors such as factor VIII Assessment of bleeding history and physical examination Evaluation for underlying autoimmune conditions or other contributory health issues Additional tests may be performed to rule out other causes of bleeding
Treatment Protocols: Bypassing agents like recombinant activated factor VII or activated prothrombin complex concentrates to control acute bleeding Immunosuppressive therapies such as corticosteroids, cyclophosphamide, or rituximab to reduce autoantibody production Plasmapheresis or immunoadsorption procedures in severe cases to remove inhibitors Treating any underlying diseases or conditions that may have triggered the autoimmune response Close monitoring and follow-up to assess treatment efficacy and prevent complications
Clinical Advice & FAQs
Billing Guidance
Is D68.311 a billable ICD-10 code?
Yes, D68.311 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report D68.311?
Clinical documentation must specify the nature of Acquired hemophilia and any associated comorbidities for accurate reporting.
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