scholarly journals Hematoma espontáneo del musculo psoas-ilíaco en pacientes con Hemofilia A: presentación de un caso y revisión de la literatura

2014 ◽  
Vol 6 (1) ◽  
pp. 73
Author(s):  
Jorge Luis Gutiérrez Cuesta ◽  
Diana Borré Naranjo ◽  
Mauricio Orozco Ugarriza
Keyword(s):  

La Hemofilia es definida como la deficiencia genética de proteínas plasmáticas denominadas factores de la coagulación e implicadas en la hemostasia. Según el tipo de factor de coagulación alterado se clasifica la enfermedad en 3 tipos: Hemofilia A (Factor VIII), Hemofilia B (Factor IX) y Hemofilia C (Factor XI). Las manifestaciones clínicas de la Hemofilia A y B son similares y se diferencian en relación al grado de deficiencia del factor de la coagulación. Las manifestaciones clínicas de la Hemofilia A se caracterizan por sangrados periódicos, particularmente a nivel de las articulaciones (Hemartrosis) y músculos (Hematomas). Los episodios de hematomas musculares ocupan el segundo lugar después de la hemartrosis, la hemorragia en el musculo psoas-ilíaco es una compilación potencialmente grave y puede resultar en manifestaciones clínicas variadas.A continuación se describe el caso clínico de un paciente de sexo masculino con Hemofilia A leve que presentó hematoma espontáneo del músculo psoas-iliaco y se analizan los tiempos de tromboplastina activado, niveles de factor VIII, otros datos de ayuda diagnóstica y finamente, se hace una revisión de la literatura.

2004 ◽  
Vol 15 (3) ◽  
pp. 241-244 ◽  
Author(s):  
Annelie Siegemund ◽  
Sirak Petros ◽  
Thomas Siegemund ◽  
Ute Scholz ◽  
Hans-Jürgen Seyfarth ◽  
...  

2013 ◽  
Vol 4 (3) ◽  
Author(s):  
Diana S Purwanto

Abstrak: Hemofilia adalah kelainan perdarahan kongenital yang disebabkan oleh kekurangan faktor VIII (faktor antihemofilik) yang terkait dengan Hemofilia A, atau faktor IX (faktor Christmas) yang terkait dengan Hemofilia B. Kedua hemophilia diturunkan secara X-linked resesif, dan umumnya ditemukan pada laki-laki. Kami melaporkan kasus seorang anak berusia 4 tahun dengan riwayat memar, pendarahan berlebihan, disertai pembengkakan sendi yang nyeri dan hematoma otot, yang dicurigai mengidap hemofilia. Serial tes koagulasi dilakukan dengan hasil: jumlah trombosit, waktu perdarahan, prothrombin time (PT), thrombin clotting time (TCT), dan fibrinogen normal, sedangkan activated partial thromboplastin time (APTT) memanjang. Mixing studies dikoreksi ketika plasma normal dan adsorbed plasma ditambahkan ke plasma pasien, yang menunjukkan defisiensi faktor VIII merupakan penyebab hemofilia ini. Aktivitas faktor VIII 8% menegaskan suatu hemofilia A derajat ringan. Kata kunci: hemofilia, PT, APTT, mixing studies, faktor VIII.   Abstract: Haemophilia is a congenital bleeding disorder caused by a deficiency of factor VIII (antihaemophilic factor), which is related to haemophilia A, or factor IX (Christmast factor), associated with haemophilia B. Both X-linked are recessive, and males are affected mostly. In this case, a four year old boy, who had a history of excessive bruising and bleeding, also suffered from painful swelling of joints and muscle hematoma. He was diagnosed of suspected  haemophilia. A serial test of coagulation studies was performed. The results of platelet count, skin bleeding time, prothrombin time, thrombin clotting time, and fibrinogen were normal; whereas, the activated partial thromboplastin time was prolonged. The mixing studies were corrected when normal plasma and adsorbed plasma were added to the patient plasma, suggesting that the factor VIII deficiency was the cause of this haemophilia. The factor VIII activity was 8% which confirmed the evidence of mild haemophilia A. Keywords: haemophilia, PT, APTT, mixing studies, factor VIII.


2021 ◽  
Vol 62 (1) ◽  
pp. 73-95
Author(s):  
Arlette Ruiz-Sáez

La hemofilia es una enfermedad hemorrágica resultante de mutaciones en el gen del factor VIII (F8) de la coagulación en el caso de la hemofilia A o en el gen del factor IX (F9) en el caso de la hemofilia B, siendo ambas formas indistinguibles clínicamente. El fenotipo clínico usualmente refleja la actividad del factor en plasma y la principal complicación del tratamiento es el desarrollo de aloanticuerpos neutralizantes. El tratamiento moderno de la hemofilia comienza a despuntarse en la década de 1970 con la disponibilidad de concentrados de factores de la coagulación de origen plasmático, el inicio de programas de profilaxis y el manejo multidisciplinario de la condición. Posteriormente, la producción de concentrados seguros, debidamente inactivados o de origen recombinante, facilitó la individualización de la terapia y el desarrollo de los agentes baipás mejoró el tratamiento de pacientes con inhibidores. Para todas esas opciones, la gran limitante ha sido la necesidad de frecuentes infusiones endovenosas por un tiempo indefinido. La biotecnología ha permitido el desarrollo de concentrados de factor VIII y IX de vida media plasmática extendida y a la producción de terapias novedosas, diferentes a la terapia de remplazo, que mejoran la coagulación o inhiben las vías anticoagulantes naturales. Por último, los progresos en la terapia génica como potencial cura de la condición generan grandes expectativas. Si bien estos avances ofrecen alternativas terapéuticas para pacientes con o sin inhibidores, aún están por definirse aspectos relacionados a sus indicaciones, monitorización y seguridad a corto y largo plazo.


Medicina ◽  
2017 ◽  
Vol 19 (2) ◽  
pp. 112-116
Author(s):  
Rocio Elizabeth Marin Panchez ◽  
Cristina Almeida Betty ◽  
Lorena Monserrate Coello ◽  
Teresa Rizzo Delgado

 Los trastornos hereditarios de la coagulación con mayor incidencia en la edad pediátrica son la hemofilia A (deficiencia factor VIII), la hemofilia B o enfermedad de Christmas (deficiencia factor IX) y la enfermedad de Von Willebrand. Siendo la hemofilia una enfermedad de tipo hereditario ligado al cromosoma X que se manifiesta con ausencia o disminución de la función de los factores de coagulación (factor VIII y IX) que impide una correcta hemostasia y consecuentemente hemorragias tanto interna como externas. Existen varias complicaciones causadas por esta patología siendo la más infrecuente el quiste hemofílico. Por este motivo se presenta el caso clínico de un paciente de 14 años de edad con diagnóstico de hemofilia reciente y a pesar de recibir tratamiento específico persistió la tumoración a nivel gemelar izquierdo. El principal objetivo es dar a conocer la importancia del diagnóstico temprano junto al manejo multidisciplinario


1998 ◽  
Vol 80 (08) ◽  
pp. 233-238 ◽  
Author(s):  
K. A. Mitropoulos ◽  
M. N. Nanjee ◽  
D. J. Howarth ◽  
J. C. Martin ◽  
M. P. Esnouf ◽  
...  

SummaryAbetalipoproteinaemia is a rare disorder of apolipoprotein B metabolism associated with extremely low plasma concentrations of triglyce-ride. To discover whether the general positive association between factor VII and triglyceride levels extends to this condition, 5 patients were compared with 18 controls. All patients had a triglyceride below 100 μmol/l. Plasma unesterified fatty acid concentration was normal. Although factor IX activity was only slightly reduced (mean 88% standard) and factor IX antigen was normal, mean activated factor VII in patients was strikingly reduced to 34% of that in controls, a level similar to that found in haemophilia B. The patients’ mean factor VII activity and factor VII antigen were also significantly reduced to 54% and 63% of those in controls, respectively. Mean factor XI activity and tissue factor pathway inhibitor activity were reduced in patients to 70% and 75% of control values respectively, while factor XII, factor XI antigen, factor X, prothrombin and protein C were normal.


1976 ◽  
Vol 35 (03) ◽  
pp. 510-521 ◽  
Author(s):  
Inga Marie Nilsson

SummaryThe incidence of living haemophiliacs in Sweden (total population 8.1 millions) is about 1:15,000 males and about 1:30,000 of the entire population. The number of haemophiliacs born in Sweden in 5-year periods between 1931-1975 (June) has remained almost unchanged. The total number of haemophilia families in Sweden is 284 (77% haemophilia A, 23% haemophilia B) with altogether 557 (436 with A and 121 with B) living haemophiliacs. Of the haemophilia A patients 40 % have severe, 18 % moderate, and 42 % mild, haemophilia. The distribution of the haemophilia B patients is about the same. Inhibitors have been demonstrated in 8% of the patients with severe haemophilia A and in 10% of those with severe haemophilia B.There are 2 main Haemophilia Centres (Stockholm, Malmo) to which haemophiliacs from the whole of Sweden are admitted for diagnosis, follow-up and treatment for severe bleedings, joint defects and surgery. Minor bleedings are treated at local hospitals in cooperation with the Haemophilia Centres. The concentrates available for treatment in haemophilia A are human fraction 1-0 (AHF-Kabi), cryoprecipitate, Antihaemophilic Factor (Hyland 4) and Kryobulin (Immuno, Wien). AHF-Kabi is the most commonly used preparation. The concentrates available for treatment in haemophilia B are Preconativ (Kabi) and Prothromplex (Immuno). Sufficient amounts of concentrates are available. In Sweden 3.2 million units of factor VIII and 1.0 million units of factor IX are given per year. Treatment is free of charge.Only 5 patients receive domiciliary treatment, but since 1958 we in Sweden have practised prophylactic treatment of boys (4–18 years old) with severe haemophilia A. At about 5-10 days interval they receive AHF in amounts sufficient to raise the AHF level to 40–50%. This regimen has reduced severe haemophilia to moderate. The joint score is identical with that found in moderate haemophilia in the same age groups. For treatment of patients with haemophilia A and haemophilia B complicated by inhibitors we have used a large dose of antigen (factor VIII or factor IX) combined with cyclophosphamide. In most cases this treatment produced satisfactory haemostasis for 5 to 30 days and prevented the secondary antibody rise.


1966 ◽  
Vol 15 (03/04) ◽  
pp. 349-364 ◽  
Author(s):  
A.H Özge ◽  
H.C Rowsell ◽  
H.G Downie ◽  
J.F Mustard

SummaryThe addition of trace amounts of adrenaline to whole blood in plasma in vitro increased factor VIII, factor IX and whole plasma activity in the thromboplastin generation test. This was dose dependent.Adrenaline infusions less than 22 (μg/kg body weight in normal dogs accelerated clotting, increased factor IX, factor VIII and whole plasma activity in the thromboplastin generation test and caused a fall in blood pH. In a factor IX deficient dog, there was no increase in factor IX activity. After adrenaline infusions, however, the other changes occurred and were of the same order of magnitude as in the normal. Adrenaline in doses greater than 22 μg/kg body weight did not produce as great an effect on clotting in normal or factor IX deficient dogs. The platelet count in the peripheral blood was increased following the infusion of all doses of adrenaline. These observations suggest that the accelerating effect of adrenaline on clotting is not mediated through increase in activity of a specific clotting factor.


1980 ◽  
Vol 44 (01) ◽  
pp. 039-042 ◽  
Author(s):  
Philip M Blatt ◽  
Doris Ménaché ◽  
Harold R Roberts

SummaryThe treatment of patients with hemophilia A and anti-Factor VIII antibodies is difficult. Between July 1977 and June 1978, a survey was carried out by an ad hoc working party of the subcommittee on Factor IX concentrates of the International Committee on Thrombosis and Hemostasis to assess the effectiveness of Prothrombin Complex Concentrates in controlling hemorrhage in these patients. The results are presented in this paper and, although subjective, support the view that these concentrates are not as effective in patients with inhibitors as Factor VIII concentrates are in patients without inhibitors.


1979 ◽  
Vol 42 (05) ◽  
pp. 1355-1367 ◽  
Author(s):  
C V Prowse ◽  
A Chirnside ◽  
R A Elton

SummaryVarious factor IX concentrates have been examined in a number of in vitro tests of thrombogenicity. The results suggest that some tests are superfluous as in concentrates with activity in any of these tests activation is revealed by a combination of the non-activated partial thromboplastin time, the thrombin (or Xa) generation time and factor VIII inhibitor bypassing activity tests. Assay of individual coagulant enzymes revealed that most concentrates contained more factor IXa than Xa. However only a small number of concentrates, chiefly those that had been purposefully activated, contained appreciable amounts of either enzyme.


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