Case presentation An elderly man suffering from moderate hemophilia A presented to the clinic with muscle stiffness and pain in the pelvic and scapular girdles. The symptoms were persistent for several weeks and were prominent towards the end of the night, lasting until morning. The patient received several infusions of clotting factor VIII at home, but it was ineffective in relieving pain. On physical examination, there were no signs of fever, headache, loss of vision, or jaw claudication.
Clinical examination revealed pain and reduced mobility in both shoulders. He had a history of hypertension, prostatic hypertrophy, and hemophilic arthropathy and was taking third-generation recombinant FVIII inhibitor, amlodipine, tamsulosin, and etoricoxib. Laboratory findings: Elevated C-reactive protein: 4.7 mg/dL Fibrinogen: 687 mg/dL Erythrocyte sedimentation rate: 67 mm/hr Basal FVIII level:…
