FEMORAL NEUROPATHY AND ILIOPSOAS HEMATOMA AS A RESULT OF POSTPARTUM FACTOR-VIII INHIBITOR SYNDROME

Femoral neuropathy secondary to iliopsoas hematoma has been documented in a variety of case reports and studies 1-3. Iliopsoas hemorrhage and femoral neuropathy can develop without any evidence of trauma in individuals who have hemophilia, particularly in those who have the acquired form of the disease and a factor inhibitor. Patients experience pain deep in the groin, and some present with contracture of the hip in acute flexion. Prolonged insult may result in permanent paresthesias, weakness, and atrophy of the quadriceps muscle. Prompt diagnosis is important because the risk of permanent injury is decreased when therapy is initiated rapidly 2. We will review a case of femoral neuropathy secondary to an iliopsoas hematoma in a woman with an acquired postpartum factor-VIII inhibitor syndrome. We present this case to heighten awareness about this unusual variant of hemophilia and the musculoskeletal sequelae that may result. Our patient was informed that data concerning the case would be submitted for publication. A twenty-nine-year-old woman presented with a three-day history of severe pain in the anterior aspect of the left hip and the proximal aspect of the left thigh. There was no history of trauma. The patient also had numbness in the lateral and the anterior aspect of the thigh, and she was having difficulty walking because she could not extend the hip without severe pain. The patient was four months postpartum and recently had been diagnosed with postpartum factor-VIII inhibitor syndrome after she had presented with spontaneous bruising of the extremities. Three days before the current presentation, she had been discharged from the hospital after being treated for a spontaneous hemorrhage in the left calf and tarsal tunnel. The medical history of this patient was otherwise unremarkable. Physical examination revealed an otherwise healthy-appearing, thin woman. The patient held the left …