Haemophilia Treatment Centre, University Hospital of Nantes and French Reference Centre on Haemophilia, Nantes, France.
Haemophilia Treatment Centre, University Hospital of Lyon and French Reference Centre on Haemophilia, Lyon, France.
Eur J Haematol. 2023 Jun;110(6):584-601. doi: 10.1111/ejh.13941. Epub 2023 Feb 20.
The rare coagulation disorders may present significant difficulties in diagnosis and management. In addition, considerable inter-individual variation in bleeding phenotype is observed amongst affected individuals, making the bleeding risk difficult to assess in affected individuals. The last international recommendations on rare inherited bleeding disorders (RIBDs) were published by the United Kingdom Haemophilia Centre Doctors' Organisation in 2014. Since then, new drugs have been marketed, news studies on surgery management in patients with RIBD have been published, and new orphan diseases have been described.
Therefore, the two main objectives of this review, based on the recent recommendations published by the French Reference Centre on Haemophilia and Rare Bleeding Disorders, are: (i) to briefly describe RIBD (clinical presentation and diagnostic work-up) to help physicians in patient screening for the early detection of such disorders; and (ii) to focus on the current management of acute haemorrhages and long term prophylaxis, surgical interventions, and pregnancy/delivery in patients with RIBD.
罕见的凝血障碍可能在诊断和管理方面带来重大困难。此外,受影响个体之间的出血表型存在相当大的个体差异,这使得难以评估受影响个体的出血风险。英国血友病中心医生组织于 2014 年发布了关于罕见遗传性出血性疾病(RIBD)的最新国际建议。自那时以来,已有新药物上市,有关 RIBD 患者手术管理的新研究已发表,并且还描述了新的孤儿病。
因此,基于法国血友病和罕见出血性疾病参考中心最近发布的建议,本次审查的两个主要目标是:(i)简要描述 RIBD(临床表现和诊断检查),以帮助医生对这些疾病进行患者筛查,从而实现早期发现;(ii)重点介绍 RIBD 患者急性出血和长期预防、手术干预以及妊娠/分娩的当前管理。