Hemophilia A differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hemophilia A}} | {{Hemophilia A}} | ||
{{CMG}}{{AE}}{{FNY}} | {{CMG}}{{AE}} {{VE}} {{FNY}} | ||
==Overview== | ==Overview== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
Other diseases which should be considered in the differential include:<ref name="pmid7886607">Hathaway WE (1993) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7886607 Vitamin K deficiency.] ''Southeast Asian J Trop Med Public Health'' 24 Suppl 1 ():5-9. PMID: [https://pubmed.gov/7886607 7886607]</ref><ref name="pmid24014073">Santagostino E, Fasulo MR (2013) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24014073 Hemophilia a and hemophilia B: different types of diseases?] ''Semin Thromb Hemost'' 39 (7):697-701. [http://dx.doi.org/10.1055/s-0033-1353996 DOI:10.1055/s-0033-1353996] PMID: [https://pubmed.gov/24014073 24014073]</ref><ref name="pmid25976956">{{cite journal| author=Israels SJ| title=Laboratory testing for platelet function disorders. | journal=Int J Lab Hematol | year= 2015 | volume= 37 Suppl 1 | issue= | pages= 18-24 | pmid=25976956 | doi=10.1111/ijlh.12346 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25976956 }}</ref><ref name="pmid199944">Lechner K, Niessner H, Thaler E (1977) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=199944 Coagulation abnormalities in liver disease.] ''Semin Thromb Hemost'' 4 (1):40-56. PMID: [https://pubmed.gov/199944 199944]</ref><ref name="pmid25408749">Buga-Corbu I, Arion C (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=25408749 Up to date concepts about Von Willebrand disease and the diagnose of this hemostatic disorder.] ''J Med Life'' 7 (3):327-34. PMID: [https://pubmed.gov/25408749 25408749]</ref><ref name="pmid16086639">Giangrande P (2005) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16086639 Haemophilia B: Christmas disease.] ''Expert Opin Pharmacother'' 6 (9):1517-24. [http://dx.doi.org/10.1517/14656566.6.9.1517 DOI:10.1517/14656566.6.9.1517] PMID: [https://pubmed.gov/16086639 16086639]</ref> | Other diseases which should be considered in the differential include:<ref name="pmid7886607">Hathaway WE (1993) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7886607 Vitamin K deficiency.] ''Southeast Asian J Trop Med Public Health'' 24 Suppl 1 ():5-9. PMID: [https://pubmed.gov/7886607 7886607]</ref><ref name="pmid24014073">Santagostino E, Fasulo MR (2013) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24014073 Hemophilia a and hemophilia B: different types of diseases?] ''Semin Thromb Hemost'' 39 (7):697-701. [http://dx.doi.org/10.1055/s-0033-1353996 DOI:10.1055/s-0033-1353996] PMID: [https://pubmed.gov/24014073 24014073]</ref><ref name="pmid25976956">{{cite journal| author=Israels SJ| title=Laboratory testing for platelet function disorders. | journal=Int J Lab Hematol | year= 2015 | volume= 37 Suppl 1 | issue= | pages= 18-24 | pmid=25976956 | doi=10.1111/ijlh.12346 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25976956 }}</ref><ref name="pmid199944">Lechner K, Niessner H, Thaler E (1977) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=199944 Coagulation abnormalities in liver disease.] ''Semin Thromb Hemost'' 4 (1):40-56. PMID: [https://pubmed.gov/199944 199944]</ref><ref name="pmid25408749">Buga-Corbu I, Arion C (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=25408749 Up to date concepts about Von Willebrand disease and the diagnose of this hemostatic disorder.] ''J Med Life'' 7 (3):327-34. PMID: [https://pubmed.gov/25408749 25408749]</ref><ref name="pmid16086639">Giangrande P (2005) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16086639 Haemophilia B: Christmas disease.] ''Expert Opin Pharmacother'' 6 (9):1517-24. [http://dx.doi.org/10.1517/14656566.6.9.1517 DOI:10.1517/14656566.6.9.1517] PMID: [https://pubmed.gov/16086639 16086639]</ref><ref>Deaton JG, Bhimji SS. Toxicity, Warfarin. [Updated 2017 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-.Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK431112/</nowiki></ref> | ||
*[[Warfarin]] toxicity | *[[Warfarin]] toxicity | ||
*[[Liver disease]] | *[[Liver disease]] | ||
*[[Vitamin K]] deficiency | *[[Vitamin K]] deficiency | ||
*[[Platelet disorder|Platelet disorders]] | |||
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Neurological findings/Ascitis | | style="background: #F5F5F5; padding: 5px; text-align: center;" |Neurological findings/Ascitis | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
Latest revision as of 09:16, 29 January 2019
Hemophilia A Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vahid Eidkhani, M.D. Fahd Yunus, M.D. [2]
Overview
Hemophilia must be differentiated from other diseases that cause abnormal or excessive bleeding.[1]
Differentiating Hemophilia A from other Diseases
The most important differential diagnosis of Hemophilia A is that of hemophilia B (also known as Christmas disease) or von Willebrand disease (the most common hereditary clotting disorder). The former is usually considered if factor VIII levels are normal in a person with a hemophilia phenotype. The latter is excluded on routine testing for that condition.
Differential Diagnosis
Other diseases which should be considered in the differential include:[2][3][4][5][6][7][8]
- Warfarin toxicity
- Liver disease
- Vitamin K deficiency
- Platelet disorders
Diseases | Clinical manifestations | Para-clinical findings | Additional findings | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | |||||||||||||||
Lab Findings | ||||||||||||||||
Joint Bleeding | Gastrointestinal bleeding | Genitourinary Bleeding | Skin Bruises | Skeletal deformity | Muscle hematoma | CBC | PT | PTT | BT | Factor VIII | Factor IX | Fibrinogen | U/A:RBC | S/E:RBC | ||
Hemophilia A | + | + | + | + | + | + | N | N | ↑ | N | ↓ | N | N | + | + | -/+Family history |
Hemophilia B | + | + | + | + | + | + | N | N | ↑ | N | N | ↓ | N | + | + | -/+Family history |
von Willebrand disease | -/+ | -/+ | -/+ | -/+ | -/+ | -/+ | N | N | ↑/N | ↑ | ↓/N | N | N | -/+ | -/+ | -/+Family history |
Vitamin K deficiency | -/+ | + | -/+ | + | - | -/+ | N | ↑ | ↑/N | N | N | ↓ | N | + | + | Mostly in Infants/GI disorders |
Warfarin Toxicity | -/+ | + | -/+ | + | - | -/+ | N | ↑ | ↑/N | N | N | ↓ | N | + | + | +Drug history |
Platelets disorders | - | -/+ | -/+ | + | - | - | ↓Plt | N | N | ↑ | N | N | N | -/+ | -/+ | Cause-based Specific findings |
Liver Failure | - | + | + | -/+ | - | -/+ | ↓Plt/N | ↑ | ↑ | ↑/N | ↑/N | ↓ | ↑/N | -/+ | + | Neurological findings/Ascitis |
References
- ↑ Konkle BA, Josephson NC, Nakaya Fletcher S. Hemophilia A. 2000 Sep 21 [Updated 2014 Jun 5]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2016. Available from: http://www-ncbi-nlm-nih-gov.laneproxy.stanford.edu/books/NBK1404/
- ↑ Hathaway WE (1993) Vitamin K deficiency. Southeast Asian J Trop Med Public Health 24 Suppl 1 ():5-9. PMID: 7886607
- ↑ Santagostino E, Fasulo MR (2013) Hemophilia a and hemophilia B: different types of diseases? Semin Thromb Hemost 39 (7):697-701. DOI:10.1055/s-0033-1353996 PMID: 24014073
- ↑ Israels SJ (2015). "Laboratory testing for platelet function disorders". Int J Lab Hematol. 37 Suppl 1: 18–24. doi:10.1111/ijlh.12346. PMID 25976956.
- ↑ Lechner K, Niessner H, Thaler E (1977) Coagulation abnormalities in liver disease. Semin Thromb Hemost 4 (1):40-56. PMID: 199944
- ↑ Buga-Corbu I, Arion C (2014) Up to date concepts about Von Willebrand disease and the diagnose of this hemostatic disorder. J Med Life 7 (3):327-34. PMID: 25408749
- ↑ Giangrande P (2005) Haemophilia B: Christmas disease. Expert Opin Pharmacother 6 (9):1517-24. DOI:10.1517/14656566.6.9.1517 PMID: 16086639
- ↑ Deaton JG, Bhimji SS. Toxicity, Warfarin. [Updated 2017 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK431112/