Hemophilia A

Hematology

Overview

Definition

X-linked recessive bleeding disorder caused by Factor VIII deficiency.

Epidemiology

Affects 1 in 5,000 males.

Etiology & Risk Factors

  • Mutation in the F8 gene

Clinical Symptoms

  • Hemarthrosis (bleeding into joints)
  • Prolonged bleeding after trauma/surgery
  • Easy bruising

Clinical Approach

Diagnosis

  • Prolonged aPTT
  • Normal PT/Bleeding time
  • Low Factor VIII assay

Management

  • Recombinant Factor VIII replacement
  • Emicizumab (monoclonal antibody)
  • Desmopressin (DDAVP) for mild cases

Complications

  • Joint destruction (hemophilic arthropathy)
  • Intracranial hemorrhage
  • Development of inhibitors (antibodies to Factor VIII)