Incidence of Subclinical Joint Bleeding among Hemophilia A Patients with Prophylaxis Therapy in Babylon Hereditary Blood Disease Center

Background: Hemophilia A is a sex-linked blood disease characterized by recurrent joint bleeding, which may progress eventually to disability in adolescence in the absence of prophylaxis therapy. Even, many patients may develop joint damage which suggests subclinical or hidden joint hemorrhage, which can be detected by ultrasound (U/S) scan and magnetic resonance imaging. Objectives: It showed the incidence of subclinical joint bleeding in hemophilia A with prophylaxis therapy and its correction with blood parameters such as hemoglobin, packed cell volume, mean corpuscular hemoglobin concentration, mean corpuscular volume. Materials and Methods: It is observational, cross-sectional study on 30 hemophilia patients, aged 3–18 years with mean age ranging 10.27 ± 3.552 years who were on prophylaxis therapy with no clinical feature of arthropathy. These hemophilia patients were evaluated clinically by using U/S scan and magnetic resonance imaging (MRI). The study period was from January 2023 to July 2023. All studied patients were evaluated for anemia clinically and confirmed by Hb and PCV and other red blood cell indices including MCV, MCHC, and serum ferritin. All patients underwent joint U/S scan and magnetic resonance imaging. Results: It showed that 26.7% and 46.7% of patients had subclinical bleeding diagnosed by U/S scan and MRI, respectively, whereas there was no significant statistically difference among all blood parameters including PCV, MCV, and MCHC despite mild reduction of serum ferritin. Conclusion: It showed that 26.7% of hemophiliac patients developed subclinical bleeding diagnosed by U/S scan and 46.7% by MRI.