Abnormal bleeding tendency associated with pure antihemophilic globulin (AHG) deficiency is rare in females. To review this subject, one is limited to the past ten years—since the advent of the thromboplastin generation test by Biggs and Douglas.1 If one attempts to evaluate reports of "hemophilia" in females prior to 1953 one can only conclude that there was a first-stage clotting defect which might have been due to a deficiency of any of the first-stage factors.
Since 1953, however, there have been a few case reports of excessive bleeding associated with low AHG levels in females from hemophilic families. Nilsson described the interesting case of a white child with classic hemophilia A and family history of AHG deficiency in the maternal line. Although the child was thought to be a female from all external appearances, tissue cultures of skin specimens and cytological studies showed 46 chromosomes with an
LUSHER JM, STAUB RT, BELOTE JH. Antihemophilic Globulin DeficiencyIn a Chromosomal Female. Am J Dis Child. 1964;108(3):309–314. doi:10.1001/archpedi.1964.02090010311014