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Clinical Notes
March 7, 1964

The Problem of Unrecognized "Mild Hemophilia"Survival of a Patient After Disarticulation of the Hip

Author Affiliations


From the departments of orthopedics and surgery, Harvard Medical School, and the Orthopedic Service (Drs. Pappas, Barr, and Riseborough), the Surgical Service (Dr. Salzman), and the Blood Bank (Dr. Britten), Massachusetts General Hospital.

JAMA. 1964;187(10):772-774. doi:10.1001/jama.1964.03060230100031

THE WORD "HEMOPHILIA" frequently conjures up the picture of a severely disabled boy or adult man, crippled by damage to his joints, and suffering from recurrent life-threatening hemorrhages. Such patients have the disease in its severe form, usually having less than 1% of normal antihemophilic factor (AHF) (factor VIII) plasma thromboplastin component or (PTC) (factor IX). Less well known is the fact that hemophiliacs with a mild form of the disease may be entirely unaware of their disability. These patients usually have more than 5% of the deficient factor, rarely have trouble with their joints, and are often able to lead a full and normal life. They are nevertheless susceptible to severe bleeding, particularly after surgery or major injury; sometimes ignorance of their inherent bleeding tendency can lead to results more serious than those in a known severe hemophiliac with the same type of bleeding because of delay in instituting

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