Recurrent Life-Threatening Lower Gastrointestinal Bleeding Secondary to Abdominal Tuberculosis in a Case of Moderate Hemophilia A

Background: Gastrointestinal tuberculosis can have a plethora of presentations, commonly abdominal discomfort, altered bowel habits, weight loss, fever, or mild rectal bleeds. Massive and recurrent life-threatening Lower Gastrointestinal Bleeding (LGI) is an unusual presentation in mild-moderate hemophilia cases. Our case is a moderate hemophilia patient with a significant recurrent GIT bleeding where ileocecal tuberculosis was identified later as the culprit.Clinical Description: We report an uncommon case of recurrent episodes of life-threatening LGI bleeding in a patient with moderate hemophilia A. The child was given factor VIII replacement therapy with each episode of bleeding. The radionuclide scintigraphy revealed the ileal origin of the bleed and contrast CT abdomen showed features suggestive of ileocaecal tuberculosis which was confirmed later microbiologically. Management and Outcome: The patient showed significant improvement after the use of anti-tubercular drugs and achieved complete remission. Conclusion: An alternate diagnosis concurrent to the non-severe form of hemophilia should always be sought as a possibility in case of severe spontaneous and recurrent LGI bleeding.