Abstract
Hemophilia is a genetic or acquired disease that leads to spontaneous and recurrent bleedings, which affect the joints and muscles, thus determining chronic damage to the cartilage which will lead to joint disease and hemophilic arthropathy. Even though hemophilic patients were initially thought to have a low incidence of atherothrombotic complications, it is now clear that atherothrombotic events occur. The administration of plasmatic factor VIII has better clinical results in type A hemophilic patients than the transfusion with plasma. We analyzed five patients with hemophilia type A, aged between 35 and 62 years. Two of them had a severe form of hemophilia with factor VIII less than 1%, while the other three had a moderate form with factor VIII ranging between 1 and 5%. The five patients underwent total knee repair interventions and received substitution treatment with clotting factors but also prophylactic anticoagulant treatment. The postsurgical evolution of these patients was favorable, with similar hemostatic profile as the non-hemophilic patients. Moroctocog alfa is an efficient substitutive treatment that manages to normalize the hemostatic profile of patients. Therefore, it is recommended to provide prophylactic antithrombotic therapy after the orthopedic interventions.
Highlights
Hemophilia is a disease that has a frequency of approximately 1 in 10,000 births
Hemophilia is a genetic or acquired disease that leads to spontaneous and recurrent bleedings, which affect the joints and muscles, determining chronic damage to the cartilage which will lead to joint disease and hemophilic arthropathy
Hemophilia should be suspected in patients with early bruising in childhood, with excessive hemorrhages after trauma or surgical intervention, or in patients with spontaneous bleeding
Summary
Hemophilia is a disease that has a frequency of approximately 1 in 10,000 births It has an X-linked transmission, and it consists in a bleeding disorder due to the deficiency of clotting factor VIII (hemophilia A) or factor IX (hemophilia B). There are two major types of hemophilia: type A and type B These disorders are X-linked and consist in hemorrhages, resulting from diminished levels of clotting factors VIII and IX. Its severity varies to the residual factor level It is classified as severe (when the clotting factor activity is less than 1%), moderate (1–5%), and mild (6–40%). If not treated hemophilic patients, especially those with very low clotting factor activity and severe disease, have recurrent disabling and life-threatening bleeding episodes. Hemophilia should be suspected in patients with early bruising in childhood, with excessive hemorrhages after trauma or surgical intervention, or in patients with spontaneous bleeding
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