Essay about Coagulation and Replacement Therapy

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Hemophilia Michelle Karlson Millersville University

Hemophilia is a rare and genetic blood clotting disorder affecting about 18,000 people in America today. It is a hereditary disorder that is passed from parent to child, normally from mothers to the sons. It can be carried by females and normally 1/4 of the children will have it. If a male has hemophilia, he cannot pass it on. However that will make his daughters carriers, so they can possibly pass it on. While it is very rare, women can also get hemophilia if the father has it and if the mother is also a carrier. “The incidence of hemophilia cuts across social, economic, geographical, and ethnic lines, and does not show a specific association to ethnic characteristics…” (Katz, 1970) Unlike other disorders, such as sickle cell anemia, hemophilia affects people of different ethnicities equally. There is currently no cure for this disease, although there are medicines that can be helpful. In fact, people need lifelong treatment for hemophilia. With the right treatment and lifestyle, including replacement therapy, medicines, and treatment centers, they can be expected to lead normal lives.
People with hemophilia have a decreased clotting factor and therefore bleed more. Contrary to popular belief, the reason for this is that blood cannot clot properly. Another myth about hemophilia is that people can bleed to death from minor injuries or cuts. In fact, more often than not the bleeding is internal and may cause arthritis or even crippling. Most people only know those two facts about hemophilia but in actuality, there is much more to know about this disease. For example, Hemophilia is a sex-linked disorder. This means that it is more prevalent in males than in women, and about one in every 10,000 males born worldwide is hemophilic. Every year one in 5,000 men are born with this disorder. (“Bleeding Disorders”, n.d.) Medical advancement has affected hemophiliacs positively because now they are likely to live to adulthood.
There are two main types of hemophilia: Hemophilia A and Hemophilia B. Hemophilia A has a factor VIII deficiency, and is four times more common with about 80% of people experiencing this type. More than half of patients with Hemophilia A have the severe type. Another name for this type is classical hemophilia. Hemophilia B has a factor IX deficiency and is known as Christmas disease. People with hemophilia B make up about 20% of the cases of people with hemophilia.
The severity of hemophilia depends on how much clotting factor is in a person’s blood not which type is missing. Clotting factor is a protein needed for people to clot their blood properly. There are three levels of severity, which include mild, moderate, and severe hemophilia. A person falls into only one severity category, and it never changes whether it is from mild to severe, severe to moderate, etc. The only changing factor is the number and type of bleeds people have, and this solely depends on their lifestyle. Mild hemophilia has 6% to 49% of factor VIII or IX in the blood of someone with hemophilia A or B, respectively. “Mild hemophilia is a manageable chronic condition and it is quite different from severe hemophilia which has more acute symptoms and is a more physically damaging form of the disease.” (Bellenir, 1996)
About 25% of all the cases of hemophilia are of a mild severity. This type is manageable and less physically and emotionally damaging than moderate and severe hemophilia. People with mild hemophilia normally only bleed after a serious physical injury. In some cases, people are not diagnosed with mild hemophilia until surgery or a serious injury. This may not happen until patients reach adulthood. Some may never have a bleeding problem, and if they do, it is uncommon for there to be joint issues. While it is very rare, women with this type usually have a heavy flow during…