Prevalence and Correlation with Disease Severit
Prevalence and Correlation with Disease Severit
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Date
2015-04-26
Authors
Abd Elwhab Mohammed, Amna
Journal Title
Journal ISSN
Volume Title
Publisher
UOFK
Abstract
Inhibitors are antibodies that neutralize coagulation factors. They are
immunoglobulin’s, arising in congenitally deficient individuals as a result of
administration of missing factors. The development of inhibitors remains one of the
most serious complications of replacement therapy in haemophilia A patients.
Inhibitors makes control of bleeding difficult as they need higher doses of factors or
bypassing agents, these are coasty and are not always available. This problem is under
estimated and needs further work up to detect the true incidence and the risk factors
and their effect on management.
Objectives: To determine the prevalence of inhibitors in patients with haemophilia
A and correlate the severity of illness with inhibitors level by measuring FVIII level
and FVIII inhibitors.
Design:Cross sectional prospective study
Setting: Haemophilia clinic in Khartoum Teaching Hospital in the period from
January to May 2010.
Methods: Eighty patients with haemophilia A were included in the study .All
patients were males with different disease severities (mild, moderate and severe).
Their ages ranged from 3-60 years. Samples were collected from patients for Factor
VIII level and inhibitor quantification. Inhibitor quantification was done by Bethesda
assay and expressed inBethesda unit (BU).
Results: Seventeen patients (21.3%) were found to have inhibitors, fifteen patients
with low titre inhibitors (18.8%) and two of high titre (2.5%). Those with high titre
inhibitors had more frequent visits to haemophilia clinic and received more units of
factor VIII during the last month.
No correlation was found between the severity of the disease and the number of visits
during the last year. Inhibitors are most common among severely diseased patients but
the correlation between the severity of the disease and the inhibitors was not
significant for those with mild and moderate disease.
Conclusion: The prevalence of factor VIII inhibitors in this group of patients with
haemophilia A was 21.3% (seventeen patients). Fifteen patients of low titre inhibitors
(18.8%) and two of high titre (2.5%).This result was significant asthe prevalence of
inhibitors was 15-25% in haemophilia A as mentioned in the literature . Inhibitors are
most common among severely diseased patients. Those with inhibitors had more
frequent visits and receive more amount offactor VIII concentrate during the last
month when compared with patients with no inhibitors .
Description
68page
Keywords
Prevalence,Correlation,Disease,Severity