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Hemophilia
> updated 3-4-05
What
is hemophilia?
Hemophilia
is a rare, hereditary bleeding disorder in which certain proteins
called clotting factors are deficient or missing. The two
most common types of hemophilia are: Hemophilia A, which is
the result of a deficiency in the clotting factor called factor
VIII, and hemophilia B, which is caused by a deficiency of
clotting factor IX. Only about 17,000 people in the US have
hemophilia in its mild, moderate or severe form.
What
are the signs & symptoms?
Prolonged bleeding after circumcision,
dental work, surgery or trauma
Internal bleeding - sometimes with no apparent trauma
or injury
Bleeding into joints, muscles or soft tissue
Excessive bruising
Abnormal Lab values (PT/PIT)
Is
hemophilia inherited?
Hemophilia
is called an X-linked generic condition since the abnormal
hemophilia gene is carried by females on one of their X chromosomes.
This will be passed on to offspring 50 percent of the time.
Statistically, 50% of sons of a female carrier will have hemophilia
and 50% of her daughters will be carriers. Daughters of males
with hemophilia will be carriers. In up to 1/3 of all cases,
there is no known family history. Hemophilia can occur as
the result of a new or spontaneous mutation.
How
is hemophilia diagnosed?
Hemophilia
is diagnosed with specialized blood testing. These tests should
be done at sites that have a coagulation lab to ensure accuracy.
In the
1950s, people were hospitalized regularly for blood transfusions
or plasma infusions to treat hemophilia. Today, people get
treatment quickly using clotting factor concentrates, making
hospitalization the exception rather than the norm.
Why
do we have special hemophilia treatment centers?
Since hemophilia
is so rare, use of the many clotting factor products is not
well understood by many physicians. Hemophilia treatment centers
focus the knowledge and skills of physicians, nurses, social
workers and other professionals experienced in hemophilia
care. Published studies show that this multidisciplinary approach
and the expert use of clotting factors result in effective
and efficient care. (P.S. Smith et. al, Am. Journal of Public
Health v74; J.M. Soucie, et.al, Journal Am. Society of Hematology
v96.)
How
is hemophilia treated?
Prior to
1986 when the test for HIV came into use, our nation's blood
supply contained HIV, Hepatitis and other viruses. These viruses
contaminated the plasma-based medicines used to treat people
with hemophilia, resulting in the deaths of approximately
half the people with hemophilia A in the U.S. Today, some
adults treated prior to 1986 are living with HIV and/or Hepatitis.
A new generation of much safer recombinanyt clotting factor
products was introduced in the early 1990s.
Hemophilia
can be treated by intravenous infusion of a replacement flotting
factor product, DDAVP, Stimatenasal spray or Amicar
tablets. The treatment depends on the nature and severity
of the bleeding problem.
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