Ulcerative Colitis in Hemophilia A Patient: Case Report

INTRODUCTION: Ulcerative colitis (UC) is a chronic inflammatory disease that affects colon while the incidence is increasing worldwide. The pathogenesis of the disease is complex and involves multi factors such genetic predisposition, defects in epithelial barrier and immune response as well as environmental factors. Combination UC with Hemophilia A, a hereditary hemorrhagic disorder, is very rare but can lead massive rectal bleeding that will be fatal for the patients. AIM: The case report present a case of a man with hemophilia A with rectal bleeding and recently diagnosed with ulcerative colitis. CASE REPORT: A 52 years old man presented with massive rectal bleeding since 3 days before admitted to hospital. The patient reported recurrent rectal bleeding for years but never continue for more than a week. He was previously diagnosed with hemophilia A since 34 years ago with factor VIII between 5 to 8 percent and receive recombinant human factor VIII routinely. Colonoscopy examination showed redness and ulcer along colon descendent and was confirmed for ulcerative colitis with histopathology analysis. The patient showed clinical improvement after administered with sulfasalazine and tranexamide acid. CONCLUSION: UC can cause fatal bleeding in patient with hemophilia A therefore early diagnosis of UC altogether with UC flare prevention, continuing FVII infusion and anti-hemorrhagic administration are the most important strategy in management UC in hemophilia A patient.