Symptoms

Severity and General Symptoms

Hemophilia A has symptoms ranging from mild to severe, all depending on the deficiency of Factor VIII. For milder patients, heavy bleeding only occurs during major traumas, such as surgery or major accidents. Severe cases of hemophiliacs can experience bleeding for no reason at all – most often into joints and muscles. The reason why hemophiliacs bleed most commonly into joints and muscles is not yet understood.

There is a huge range of possible severities. By comparing the amount of clotting factors in hemophiliacs with the amount in average people, doctors and scientists have created a scale to measure the severity of hemophilia's symptoms. An average person can have a clotting factor amount fifty to one hundred fifty percent off of the mean value. Mild cases of Hemophilia A have a clotting factor value of five to forty percent of the mean amount. Moderately affected hemophiliacs have a clotting factor percentile of one to five of the mean amount. Finally, severe cases of hemophilia have clotting percentages less than one percent off of the mean value.

This chart compares the clotting percentages between the different severities of Hemophilia A, and distinguishes their common symptoms.

Amount of Clotting Factor VIII	Classification	Clinical
1% of normal amount	Severe	Spontaneous joint and muscle bleeding; bleeding after injuries, accidents, and surgery
1-5% of normal amount	Moderate	Bleeding into joints and muscles after minor injury; excessive bleeding after surgery and dental extractions,
5-40% of normal amount	Mild	Spontaneous bleeding does not occur; bleeding transpires after surgery, dental extractions, and accidents

Information for the table is from “ Bolton-Maggs, Paul H B, K John Pasi. "Haemophilias A and B." The Lancet Vol. 361(2003): 1801-1809 .”

 

Early Signs of Hemophilia

Severe hemophiliacs often experience excessive bleeding prior to eighteen months of age. When a male baby has a circumcision, an unusually large amount of bleeding is a sign for hemophilia. Another early sign of hemophilia is bleeding into the scalp after birth. Bleeding gums, tongue, and mouth, is also seen in babies when they begin to grow in their sharp teeth. Young children are at the highest risk of bleeding due to their frequent falls and tumbles. Bumps and bruises are common to see on toddlers, but treatment is usually unnecessary. Bleeding into joints and muscles is seen more often after the age of two. This type of bleeding is often more painful and serious.

As children grow older, symptoms usually decrease. This does not happen because the case of hemophilia is less severe, but because of the experience and precaution that hemophiliacs learn throughout childhood.

 

Dangerous Symptoms

An x-ray of a hemophiliac's elbow, damaged from joint bleeding.

The most common dangerous symptoms for hemophiliacs are bleeding into the brain and bleeding into the joints. A hemorrhage in the brain can result in permanent brain damage or death. Bleeding into the joints can lead to permanent joint damage, the deterioration of muscles, and a loss of motion. Bleeding into muscles can also result into much pain and muscle damage. An uncontrollable amount of bleeding is also possible, which could then result in death.

There are also many other bleeding places that can be potentially dangerous. Bleeding in the neck, throat, or tongue can block off a person's airway. Hemorrhages in the iliopsas muscles across the pelvis (muscles that flex legs and lower back) can damage important nerves to the leg. Bleeding in the forearm or calf could also damage vital nerves that are important to the hand and foot. When serious symptoms such as these occur, contact 911 or see a doctor as soon as possible.

 

Sources for this page are:

•  "Bleeding Disorders, Factor Deficencies." Canadian Hemophilia Society. 2006. Canadian Hemophilia Society. 21 Nov 2006 < http://www.hemophilia.ca. >

•  Bolton-Maggs, Paul H B, K John Pasi. "Haemophilias A and B." The Lancet Vol. 361(2003): 1801-1809.

•  Wilson, Jennifer F., MS. "Hemophilia." Gale Encyclopedia of Medicine . Ed. Jacqueline L. Longe. 3rd ed. Detroit : Thomson Gale, 2006. Science Resource Center . Thomson Gale. 28 November 2006