Both hemophilia and thrombocytopenia can affect your blood’s ability to clot, leading to excess bleeding inside and outside of the body. They can cause similar symptoms, but they have different causes and treatments.

Blood clotting helps to lower bleeding after an injury. When this process doesn’t proceed as it should, it can lead to excess bleeding when blood vessels are injured.

Hemophilia and thrombocytopenia are two conditions that can cause you to bleed more easily than usual. But there are also many important differences between them. Continue reading to learn more.

Hemophilia and thrombocytopenia are two different conditions. But they each affect your blood’s ability to clot properly.

People with hemophilia have low levels of specific clotting factors in their blood. Clotting factors are proteins that work with platelets to help your blood’s ability to clot.

Thrombocytopenia is when you have a low count of platelets, which are tiny blood cells that clump together to form blood clots after an injury. Thrombocytopenia will occur when the platelet count drops below 150,000 platelets per microliter of blood.

Hemophilia and thrombocytopenia each affect blood clotting in different ways.


With hemophilia, you have low levels of clotting factors. They’re typically inactive in the blood, but signaling by platelets following an injury can activate them.

Because people with hemophilia have low levels of clotting factors, their blood clots more slowly. This can lead to excess bleeding, both inside and outside of the body.

The two common types of hemophilia are:

  • hemophilia A, which is caused by low levels of clotting factor VIII
  • hemophilia B, which is caused by low levels of clotting factor IX


Thrombocytopenia happens when the number of platelets in your blood is too low. Platelets are a tiny type of blood cell that’s made from larger cells in your bone marrow.

When you get an injury, many platelets clump together to form a blood clot. They also signal to activate clotting factors.

Similar to hemophilia, if you have thrombocytopenia, your blood won’t clot as quickly after an injury. This can lead to more bleeding inside or outside of the body.

Hemophilia doesn’t cause thrombocytopenia, nor does thrombocytopenia lead to hemophilia. But in rare cases, both may occur together, as we’ll discuss later.

According to a 2017 review, platelet function may be reduced in some people with hemophilia. But additional research is needed on this.

What causes hemophilia?

Hemophilia is usually an inherited condition. It’s inherited in an autosomal recessive manner. This means you need two copies of a faulty gene — one from your mother and one from your father — to have hemophilia.

What causes thrombocytopenia?

Thrombocytopenia can have many causes. A few examples include:

excess bleedingXX
joint bleedingX
enlarged liver or spleenX
spots under the skin (red, brown, purple)X
easy bruisingXX
frequent nosebleedsXX
bleeding gumsXX
blood in urine and stoolXX
heavy menstrual effectsXX
blood buildup in soft tissuesXX

Thrombocytopenia is a platelet disorder. Platelet disorders happen when your platelet count is too high or too low.

Conditions called thrombocythemia and thrombocytosis can cause a high platelet count. This can lead to a higher risk of serious blood clots. These clots may also use up available platelets, leading to increased bleeding in some cases.

Some specific subtypes of thrombocytopenia include:

  • Immune thrombocytopenia (ITP): ITP is an autoimmune condition in which your immune system mistakenly attacks and destroys platelets.
  • Thrombotic thrombocytopenic purpura (TTP): TTP happens when clots form in small blood vessels. This uses up platelets that could otherwise be utilized to stop bleeding after an injury.

There are different treatments for hemophilia and thrombocytopenia.

Treatment for hemophilia

Hemophilia treatment includes replacing the missing clotting factors. This is typically done to stop a bleeding episode or to limit bleeding prior to a medical procedure.

People with severe hemophilia may need to replace clotting factors prophylactically to prevent a potentially life threatening bleeding event. This can be done either at home or at a medical facility.

Doctors may prescribe medications to treat hemophilia. Medications are more often prescribed for mild hemophilia, and they include desmopressin and tranexamic acid.

Treatment for thrombocytopenia

Mild thrombocytopenia may not require any treatment. Generally, doctors suggest treatment for thrombocytopenia based on its underlying cause.

For example, doctors prescribe steroids and intravenous immunoglobulin (IVIG) for ITP. They may also prescribe immunosuppressive drugs or other drugs that help boost platelet count.

In cases of severe thrombocytopenia, a platelet transfusion may be necessary. Removal of the spleen may also help some people with thrombocytopenia.

Can they be treated at the same time?

It’s rare for hemophilia and thrombocytopenia to occur together. But there’s evidence of this happening in older case reports from 1984 and 1986, as well as a newer one from 2018.

Since hemophilia and thrombocytopenia happen due to different mechanisms, they can be treated at the same time.

For example, an older case report from 2002 describes a child with both mild hemophilia and ITP. The child was given vasopressin (which works the same way as desmopressin) to treat the hemophilia. IVIG was used to treat the ITP.

Hemophilia and thrombocytopenia are conditions that can cause excess bleeding. Hemophilia happens due to low levels of certain clotting factors, while thrombocytopenia occurs due to low platelet levels.

Treatments for both these conditions are different. While it’s possible to have hemophilia and thrombocytopenia together, this situation is rare. If this does occur, both conditions can generally be addressed at the same time.