Payal Vikas, Sharma Pramod, Goyal Vishnu, Jora Rakesh, Parakh Manish, Payal Deepika
Department of Pediatrics, Umaid Hospital, Dr. S. N. Medical College, Jodhpur, India.
Department of Radio Diagnosis, SMS Medical College, Jaipur, Rajasthan, India.
Asian J Transfus Sci. 2016 Jan-Jun;10(1):101-4. doi: 10.4103/0973-6247.164269.
Hemophilia is widely distributed all over the world, but little is known about its clinical profile in resource-limited regions. An insight into its clinical spectrum will help in the formulation of policies to improve the situation in these areas.
To study the clinical profile of hemophiliacs (age <18 years) in Jodhpur region and screen them for transfusion-transmitted infections.
A cross-sectional study conducted in the Department of Pediatrics, Umaid Hospital, Dr. S. N. Medical College, Jodhpur, over a period of 12 months.
Out of a total of 56 cases enrolled, 51 (91%) cases were diagnosed as hemophilia A while 5 (9%) were diagnosed as hemophilia B. Positive family history was found in 26 (46%) cases. According to their factor levels, 25 (44%) cases had severe disease, 20 (36%) had moderate disease, and 11 (20%) had mild disease. The mean age of onset of symptoms and diagnosis was 1.73 ± 1.43 and 3.87 ± 3.84 years, respectively. First clinical presentation was posttraumatic bleed in 20 (36%), gum bleeds in 17 (30%), epistaxis in 4 (7%), joint bleeds in 4 (7%), skin bleeds in 4 (7%), and circumcision bleed in 3 (5%) cases. Knee joint was the predominant joint affected by hemarthrosis in 38 (68%), followed by ankle in 29 (52%), elbow in 20 (36%), and hip joint in 7 (13%) cases. All patients had a negative screening test for transfusion-transmitted infections.
Occurrence of posttraumatic bleeds and gum bleeds in an otherwise normal child should warn the clinician for evaluation of hemophilia.
血友病在全球广泛分布,但在资源有限地区其临床特征鲜为人知。深入了解其临床谱将有助于制定改善这些地区状况的政策。
研究焦特布尔地区18岁以下血友病患者的临床特征,并对他们进行输血传播感染筛查。
在焦特布尔市S.N.医学院乌迈德医院儿科进行了为期12个月的横断面研究。
在纳入的56例病例中,51例(91%)被诊断为甲型血友病,5例(9%)被诊断为乙型血友病。26例(46%)有阳性家族史。根据其因子水平,25例(44%)为重型疾病,20例(36%)为中型疾病,11例(20%)为轻型疾病。症状出现和诊断的平均年龄分别为1.73±1.43岁和3.87±3.84岁。首次临床表现为创伤后出血20例(36%)、牙龈出血17例(30%)、鼻出血4例(7%)、关节出血4例(7%)、皮肤出血4例(7%)、包皮环切术后出血3例(5%)。膝关节是血友病性关节病最常受累的关节,有38例(68%),其次是踝关节29例(52%)、肘关节20例(36%)、髋关节7例(13%)。所有患者输血传播感染筛查均为阴性。
在其他方面正常的儿童中出现创伤后出血和牙龈出血应提醒临床医生评估是否患有血友病。