Hemophilia A

Definition

Hereditary clotting factor deficiencies leading to bleeding.

Signs & Symptoms

Profuse post-circumcision hemorrhage in infants, joint and soft tissue bleeds and excessive bruising, prolonged bleeding after dental extractions, spontaneous hematuria and GIT hemorrhage, recurrent painful hemarthroses and muscle hematomas, poor treatment leads to progressive joint deformity and disability.

Causes

Sex-linked inherited defect leading to absence or low levels of plasma factor VIII.

Peripheral blood characteristics

Lymphocytosis with small lymphocytes. Smudge or smear cells may be present. Normochormic normocytic anemia due to marrow infiltration or hypersplenism.

Important investigations & related results

Prolonged APTT, normal PT and bleeding time. Low factor VIII levels.

Treatment & management

Factor VIII replacement therapy and DDAVP (desmopressin).

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