Hemophilia A

Written by April Kahn | Published on June 25, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

Hemophilia A

Hemophilia A is the most common form of the blood clotting disorder hemophilia. According to the National Heart, Lung and Blood Institute, nine out of 10 people with hemophilia have hemophilia A (NHLBI, 2011). Hemophilia is a condition that causes prolonged bleeding due to a deficiency in a specific blood clotting factor. People with hemophilia A have a deficiency in blood clotting factor VIII.

Hemophilia A is an incurable genetic disorder, but it can be managed with proper treatment.

What Causes Hemophilia A?

Hemophilia A is caused by a defective gene passed on to a male child by his mother. The mother is only a carrier of this gene, so she is unaffected by the condition. The defective gene causes a deficiency in factor VIII, which helps blood to clot. According to the Centers for Disease Control and Prevention, about 20,000 males in the United States have hemophilia. Hemophilia A is four times more common than hemophilia B (CDC, 2011). Hemophilia B is caused by a deficiency of clotting factor IX.

When you bleed, your body forms a clot to close the wound in a process called coagulation. For coagulation to occur properly, all 13 of your body’s clotting factors must be present. If there is a deficiency in one or more of these factors, bleeding may continue.

Symptoms of Hemophilia A

Hemophilia A may be mild, moderate, or severe. Depending on the degree of severity, symptoms may differ.

Common symptoms of hemophilia A are:

  • prolonged bleeding, even from small wounds
  • tight joints (due to blood pooling in the joints)
  • unexplained bruises
  • nose bleeds
  • blood in the urine
  • blood in the stool

If you experience any of the symptoms of hemophilia A, contact your doctor. If you are pregnant and experience these symptoms, seek emergency care at once. Seek medical care immediately if you are bleeding profusely.

The following are emergency symptoms that should be treated immediately:

  • swollen joints
  • warm, enlarged joints
  • excruciating headache
  • repeated vomiting
  • double vision
  • continuous bleeding from an injury
  • extreme fatigue

If you have severe hemophilia A and you’ve sustained an injury that has caused bleeding, seek medical attention immediately.

Diagnosing Hemophilia A

A brief medical history and a discussion of your symptoms may be enough for your doctor to suspect hemophilia. To tell if you have hemophilia A, you will need a blood test.

People with a family history of hemophilia often have their sons tested for the condition soon after birth. The presence of hemophilia A or B is generally determined using a blood test. A small blood sample is checked for the levels of blood clotting factors VIII and IX. Adults are diagnosed using the same method.

Treating Hemophilia A

Treating hemophilia involves replacing the missing factor VIII in your blood. This is usually achieved using injections of factor VIII derived from donor blood or created in a laboratory. You may need several infusions for your level of factor VIII to rise significantly. Factor injections are not a cure for hemophilia A, but they can minimize the number and severity of bleeding episodes you experience.

A hormone called desmopressin may also be helpful in stopping bleeding. This medication is injected into a vein. It makes its way through the bloodstream, stimulating the production of clotting factors.

Complications Caused by Hemophilia A

Complications of hemophilia A are caused by prolonged and recurrent episodes of bleeding and bleeding into the joints. Over time, bleeding into the joints can cause the joints to become damaged. This can result in lifelong joint pain and limited mobility.

Other complications include:

  • arthritis
  • bleeding into the muscles, causing the muscles to swell and putting pressure on the nerves. Numbness or pain in the limbs may occur as a result.
  • allergic reaction to derived clotting factors used for treatment

Preventing Bleeding Episodes

You can help prevent internal bleeding by avoiding:

  • contact sports
  • herbal supplements (without the permission of your doctor)
  • aspirin
  • ibuprofen
  • warfarin

Brush and floss your teeth regularly to reduce the risk of developing gingivitis (gum disease). Gingivitis can cause sporadic gum bleeding.

Also, ensure that your child wears safety equipment when playing, such as a helmet and kneepads, to avoid injuries that can lead to bleeding.

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