A 24-year-old female patient presents to the hospital with pain in the left iliac fossa. A physical exam reveals a large hematoma of the psoas. She was followed for rheumatoid arthritis and was treated with corticosteroids and methotrexate. Blood workup showed anemia (hemoglobin 7 g/dL), an isolated prolongation of activated partial thromboplastin time (ratio 2.27) with a prothrombin time at 100%. What is the most likely diagnosis?

1.Acquired hemophilia
2.Antiphospholipid syndrome
3.Methotrexate toxicity
4.Factor XII deficiency

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