Bilateral DVTs in Hemophilia A, A Case Not Anticoagulated

A male in his early twenties, who participates in mixed martial arts (MMA) fighting with a past medical history of Hemophilia A but otherwise healthy, presented to the emergency room with a chief complaint of a two-day history of right lower extremity swelling, limiting his ability to walk. Of note, the patient had been self-administering recombinant Factor VIII (FVIII) for 12 years. His most recent self-injection had been the night before the onset of swelling and pain. On examination, his right calf was 2 inches in diameter wider than the left. Bilateral lower extremity venous doppler ultrasounds revealed bilateral acute non-obstructing popliteal vein thromboses.