hand book for dental surgeons - Indian Dental Association ...

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Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders
Among the various disorders of secondary hemostatisis most well known and common is haemophilia
A. It has an incidence of 1 or 2/100000 of the population and it is caused by a deficiency of antihemophilic
globulin (AHG or Factor 8) in the plasma. It is inherited as a sex-linked recessive character, appearing only in
males and transmitted to them by clinically normal female carriers. The defective gene on the X chromosome
causes a deficiency of Factor 8, Normal plasma contains one unit of a factor 8 per ml. or 100% level.
Deficiency of factor is expressed as percentage (0.25unit/ml=25%). Patients with less than 1% AHG have
severe disease. They bleed frequently into soft tissues, muscles and weight bearing joints even without
discernible trauma. When level is between 1-5%, it indicates moderate disease and there are less severe
bleeding episodes. Levels above 5% have mild disease in which there is infrequent bleeding usually secondary
to trauma or surgery levels above 25% cause no troubles unless patient suffers from major trauma. Majority of
patients have level of factor 8 less than 5%.
The clotting time is not prolonged until the level of AHG falls below 1%. The only safe test is to
estimate the AHG level in the patient for diagnosing the presence of this disease.
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Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders