Reconstituted human fibrinogen in the treatment of hemophilia: Report of a case

Abstract

The 7-year-old son of an airman was seen in the Oral Surgery Service at Fitzsimons General Hospital on Dec. 5, 1962, complaining of a “sore tooth.” Oral Eza?nination.-Intraoral inspection disclosed that a deciduous maxillary central incisor was slightly mobile and tender to percussion, with a labial fistulous tract from the apex of the tooth. There was also hemorrhagic diffusion into the gingival tissues surrounding t,he opening of the fistula. Further examination revealed multiple carious lesions, retarded eruption of teeth, and poor oral hygiene. History of Present Illness.-The patient’s father was questioned, and it was revealed that the right central incisor had been opened and drained in June, 1962, but that extraction was deferred because the boy was a “bleeder.” It was noted that the patient was wearing a brace on his left leg. Further questioning elicited the information that an apparent hemarthrosis with moderate fusion had developed in June, 1961, as a result of a minor injury to the left knee. With this initial information available, the patient’s medical records were requested and his past history was reviewed. Past History.-Medical records revealed that a circumcision in the neonatal period had been followed by oozing for a long but undetermined period of time. The patient was identified as a hemophiliac in 1958 following a knee injury. Hematologic studies at that time demonstrated the absence of antihemophilic globulin. The patient continued to have bleeding episodes following minor contusions, with resultant massive ecchymoses. In August, 1960, a prolonged hemorrhage following the extraction of two teeth was controlled by the administration of forty-one units of fresh-frozen plasma. This traumatic event was complicated by