Summary
Definition
History and exam
Key diagnostic factors
- history of recurrent or severe bleeding
- bleeding into muscles
- prolonged bleeding following heel stick or circumcision
- mucocutaneous bleeding
- hemarthrosis
- intracranial bleeding
Other diagnostic factors
- excessive bruising/hematoma
- fatigue
- menorrhagia and bleeding following surgical procedures or childbirth (female carriers)
- extensive cutaneous purpura (acquired hemophilia)
- gastrointestinal bleeding and hematuria
- distended and painful abdomen
- pallor, tachycardia, tachypnea, or hypotension
Risk factors
- family history of hemophilia (congenital hemophilia)
- male sex (congenital hemophilia)
- age >60 years (acquired hemophilia)
- autoimmune disorders, inflammatory bowel disease, diabetes, hepatitis, pregnancy, postpartum, or malignancy (acquired hemophilia)
Diagnostic investigations
Treatment algorithm
Contributors
Authors
Clinical Professor
Departments of Medicine, Pediatrics and Oncology
Cumming School of Medicine
University of Calgary
Calgary
Canada
Disclosures
M-CP has been an ad hoc speaker for Bayer, Novo Nordisk, and Pfizer; attended advisory board meetings of Biogen Idec, Baxalta/Shire, CSL Behring, Novo Nordisk, Octapharma, Pfizer, and Roche; received grant funding from CSL Behring and Bayer; and undertaken contract research for Novo Nordisk.
Clinical Assistant Professor
Department of Medicine
Cumming School of Medicine
University of Calgary
Calgary
Canada
Disclosures
AL declares that she has no competing interests.
Professor Poon and Dr Lee would like to gratefully acknowledge Dr Nigel S. Key, Dr Paul Giangrande, Dr Nidra I. Rodriguez, and Dr W. Keith Hoots, the previous contributors to this topic.
Peer reviewers
The Mary Weinfeld Professor of Clinical Research in Hemophilia
Mount Sinai School of Medicine
New York
NY
Disclosures
LA declares that he has no competing interests.
Associate Professor of Medicine
Innsbruck Medical University
Innsbruck
Austria
Disclosures
CP declares that he has no competing interests.
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