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INTRODUCTION: Coagulation factor deficit is a very uncommon hemostatic condition in which a single component or numerous factors are lacking. Hereditary coagulation factor defects are autosomal recessive, meaning that they can affect both men and women. However, hemophilia A, caused by lack of clotting factor VIII (FVIII), is an X-linked condition. Acquired hemophilia A (AHA) is a bleeding disorder caused by autoantibodies to FVIII. It should be distinguished from congenital hemophilia, an inherited disorder caused by a mutation in the FVIII gene. Here, we report the first known case in Indonesia, a 24-year-old female diagnosed with AHA. CASE PRESENTATION: A 24-year-old woman was referred to our facility for prolonged epistaxis. She had no previous history of extended menstrual flow or frequent epistaxis episodes, and there was no history of epistaxis or prolonged bleeding in her family. Bleeding time and prothrombin time were both normal, but time to activate partial thromboplastin was longer. The patient was diagnosed with AHA after von Willebrand disease (VWD) was ruled out. DISCUSSION: In some rare situations, females can be affected by X-linked illnesses such as hemophilia A and B. This may be due to a carrier mother or affected father, skewed X chromosome inactivation, Turner syndrome, inhibitory antibodies (acquired hemophilia), or a random mutation on the active X chromosome. In such instances, treatment is challenging. The usual treatment of choice is recombinant coagulation factors. CONCLUSION: Although VWD is the most frequent hereditary bleeding problem in females, other rare disorders such as AHA may be implicated. Clinicians should be aware of this when faced with patients that lack a history of bleeding disorders. Furthermore, AHA should be considered as a differential diagnosis in every female patient suffering from hemorrhage. Therefore, a comprehensive diagnostic approach is needed.

Frailty is an age-related biological syndrome characterized by a decrease in physiological capacity and stress resistance as a result of a gradual decline in the body's physiological systems. Frailty syndrome is categorized into three categories: robust / fit, pre-frail, and frail. As a crucial aspect of immunosenescence, the presence of chronic "inflamm-aging" systemic inflammation characterizes aging. Proinflammatory cytokines, such as IL-6, increased in response to a rise in molecular inflammation as people got older. The goal of this study was to investigate the levels of IL-6 in older people dependent on their frailty status. Methods: This study used a cross-sectional design with 90 patients with frailty syndrome aged >=60 years who met the research requirements at Wahidin Sudirohusodo Hospital Makassar's Geriatric Polyclinic. The Cardiovascular Health Study (CHS) scoring system is used to assess frailty syndrome. The Anova and Kruskal-Wallis tests were used in the statistical analysis, and the results were considered significant if the p-value was less than 0.05. Results: Males made up the majority of the participants (54.4%), while females made up the rest (45.6 percent ). The most common form of weakness is frailty (43.3 percent ). Frail people had the highest levels of interleukin-6 (31.1213.40), compared to pre-frail people (22.503.29) and robust people (18.532.04). There was a statistically significant difference. Age >=70 years (27.019.02) and age 60-69 years (24.7110.94) had higher IL-6 levels. There was a statistically significant difference. Only at the age of 60-69 years did IL-6 levels change significantly between robust, pre-frail, and frail people. Conclusions: In subjects 60-69 years old, IL-6 levels increased in proportion to the severity of frailty. Interleukin-6 levels did not vary according to the severity of frailty status in population over the age of 70

Background: Coronavirus disease 2019 (COVID-19) is a viral pneumonia infection that spreads rapidly globally (with a number of cases > 15,000,000 worldwide and mortality of ±4%) until it is designated a pandemic by the World Health Organization (WHO). One of the complications of COVID-19 is the incidence of coagulopathy and thromboembolism. The coronavirus, SARS-CoV-2, activates inflammatory and thrombotic processes. Coagulopathy and abnormal coagulation parameters are indicated among the most significant biomarkers of poor prognosis in COVID-19 patients. COVID-19-associated coagulopathy is characterized by a decreased platelet count and the presence of a cytokine storm indicating an extreme hypercoagulable state. This study aims to determine the coagulation profile of moderate-severe patients and outcomes in COVID-19 patients Methods: The study was conducted in a hospital in Makassar: Infection Center RS. Wahidin Sudirohusodo. Medical Record Data for all inpatients who have been diagnosed with COVID-19 through the RT-PCR test taken from January 2021-August 2021.Statistical tests in the form of the Kolmogorov-Smirnov test to assess the Normality of the Data, Chi-Square test, and the calculation of the out ratio (OR) Mann-Whitney test, Independent T-Test. Multivariate analysis was carried out using a Multiple Logistic Regression-Backward Wald Method. The results of the statistical test were significant if the p-value <0.05.   Results: The research subjects were 231 patients with confirmed COVID-19. The mean PT, D-Dimer, and Fibrinogen were higher in severe COVID-19 than moderate COVID-19 and had significant results. While PLT did not have significant results against moderate-severe COVID-19. The relationship between groups of coagulation marker variables was found to have a significant relationship with moderate to severe COVID-19. 4.     All coagulation markers were significantly related to the outcome (p<0.05). The mean value of each variable was found to be greater in patients with outcomes who died   Conclusion: There was an increase in all coagulation markers in moderate to severe COVID-19 except for PLT which was not significant. All coagulation markers are significantly related to outcome