Case history
Case history #1
An 18-month-old boy presents with left ankle swelling and pain. He has limited range of motion at the ankle and has difficulty walking. Over the last year, he has presented with significant hematomas at immunization sites. He also had prolonged bleeding after heel stick for neonatal screening tests.
Case history #2
A 6-year-old boy presents with prolonged bleeding after trauma to the oral cavity.
Other presentations
The age of presentation and bleeding frequency are influenced by the severity of the condition. Most patients are diagnosed as children. Less commonly, hemophilia may present in a newborn child. Signs of intracranial hemorrhage in a newborn child may include hypoactivity, decreased oral intake, and a bulging/tense fontanelle. Some patients may go undiagnosed until adulthood, particularly those with mild or even moderate hemophilia who have had no significant hemostatic challenges in their lives.
Hemophilia is usually an inherited disorder. However, an acquired form occasionally occurs, typically in the elderly. Acquired hemophilia may present with bleeding into the skin (purpura), soft tissues, and mucous membranes. Musculoskeletal bleeding is less common than in congenital hemophilia. In approximately 50% of cases, there is an association between acquired hemophilia and other conditions, including autoimmune disorders, inflammatory bowel disease, diabetes, hepatitis, pregnancy and the postpartum period, malignancy, monoclonal gammopathies, and use of certain drugs.[3]
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