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{{Hemophilia}}
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{{CMG}}; {{AE}} {{Simrat}}
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==Overview==
==Overview==
Physical examination of patients with hemophilia is usually remarkable with signs of bleeding in the mouth from a cut or a bite or from cutting or losing a tooth, nosebleeds, heavy bleeding from a minor cut, bleeding from a cut that resumes after stopping for a short time, blood in the urine, blood in the stool, and large bruises.  
[[Patient|Patients]] with hemophilia usually appear normal. [[Physical examination]] of [[Patient|patients]] with hemophilia is usually remarkable for [[tachycardia]], [[pallor]], [[Bruise|bruising]], [[abdominal pain]] and [[distension]], [[hypotension]], and [[muscle]] or [[joint]] [[Edema|swelling]].


==Physical Examination==
==Physical Examination==
[[Physical examination]] of [[Patient|patients]] with hemophilia is usually remarkable for [[tachycardia]], [[pallor]], [[hypotension]], and [[muscle]] or [[joint]] [[Edema|swelling]].<ref name="pmid24176587">{{cite journal |vauthors=Pham TV, Sorenson CA, Nable JV |title=Acquired factor VIII deficiency presenting with compartment syndrome |journal=Am J Emerg Med |volume=32 |issue=2 |pages=195.e1–2 |date=February 2014 |pmid=24176587 |doi=10.1016/j.ajem.2013.09.022 |url=}}</ref><ref name="pmid24914744">{{cite journal |vauthors=De la Corte-Rodriguez H, Rodriguez-Merchan EC |title=Treatment of muscle haematomas in haemophiliacs with special emphasis on percutaneous drainage |journal=Blood Coagul. Fibrinolysis |volume=25 |issue=8 |pages=787–94 |date=December 2014 |pmid=24914744 |doi=10.1097/MBC.0000000000000159 |url=}}</ref><ref>{{cite book | last = Peterson | first = Lars | title = Sports injuries : their prevention and treatment | publisher = Martin Dunitz | location = London | year = 2001 | isbn = 0203419561 }}</ref><ref name="pmid27853081">{{cite journal |vauthors=Tsuyama N, Ichiba T, Naito H |title=Unusual Initial Manifestation of Acquired Hemophilia A: A Normal Activated Partial Thromboplastin Time, Intramuscular Hematoma and Cerebral Hemorrhage |journal=Intern. Med. |volume=55 |issue=22 |pages=3347–3349 |date=2016 |pmid=27853081 |pmc=5173506 |doi=10.2169/internalmedicine.55.7219 |url=}}</ref><ref name="PitcherBowley2002">{{cite journal|last1=Pitcher|first1=G. J.|last2=Bowley|first2=D. M. G.|last3=Chasumba|first3=G.|last4=Zuckerman|first4=M.|title=Life-threatening haemorrhage from a gastric Dieulafoy lesion in a child with haemophilia|journal=Haemophilia|volume=8|issue=5|year=2002|pages=719–720|issn=1351-8216|doi=10.1046/j.1365-2516.2002.00675.x}}</ref>
===Appearance of the Patient===
===Appearance of the Patient===
===Vitals===
[[Patient|Patients]] with hemophilia usually appear normal.
====Temperature====
===Vital Signs===
====Pulse====
*[[Tachycardia]]<ref name="pmid24176587">{{cite journal |vauthors=Pham TV, Sorenson CA, Nable JV |title=Acquired factor VIII deficiency presenting with compartment syndrome |journal=Am J Emerg Med |volume=32 |issue=2 |pages=195.e1–2 |date=February 2014 |pmid=24176587 |doi=10.1016/j.ajem.2013.09.022 |url=}}</ref><ref name="pmid20505535">{{cite journal |vauthors=DeWitt ES, DiMichele DM, Larsen K, Pass RH |title=Successful cryoablation of atrioventricular nodal reentrant tachycardia in a child with hemophilia A |journal=J. Pediatr. Hematol. Oncol. |volume=32 |issue=5 |pages=404–6 |date=July 2010 |pmid=20505535 |doi=10.1097/MPH.0b013e3181e0040d |url=}}</ref>
=====Rate=====
*[[Hypothermia]]<ref name="pmid22385799">{{cite journal |vauthors=Peltier J, Baroncini M, Thines L, Leteurtre S, Marey A, Vinchon M |title=[Haemophilia A and intracranial bleedings in infants] |language=French |journal=Neurochirurgie |volume=58 |issue=1 |pages=19–24 |date=February 2012 |pmid=22385799 |doi=10.1016/j.neuchi.2012.01.003 |url=}}</ref>
*[[Tachycardia]] may be present
*[[Hypotension]]<ref name="pmid24176587">{{cite journal |vauthors=Pham TV, Sorenson CA, Nable JV |title=Acquired factor VIII deficiency presenting with compartment syndrome |journal=Am J Emerg Med |volume=32 |issue=2 |pages=195.e1–2 |date=February 2014 |pmid=24176587 |doi=10.1016/j.ajem.2013.09.022 |url=}}</ref>
=====Rhythm=====
=====Strength=====
=====Symmetry=====
====Blood Pressure====
*[[Hypotension]] may be present
*[[Orthostasis]] may be present
====Respiratory Rate====
*[[Tachypnea]] may be present
===Skin===
===Skin===
*[[Cyanosis]] may be present
*Warmth over [[Joint|joints]]<ref name="FranchiniMannucci2013">{{cite journal|last1=Franchini|first1=Massimo|last2=Mannucci|first2=Pier Mannuccio|title=Hemophilia A in the third millennium|journal=Blood Reviews|volume=27|issue=4|year=2013|pages=179–184|issn=0268960X|doi=10.1016/j.blre.2013.06.002}}</ref>
*[[Jaundice]] may be present
*[[Bruise|Ecchymosis]]<ref name="pmid23018565">{{cite journal |vauthors=Shen CY, Fu LS, Lin HK, Han SM, Wang JD |title=Macrohematuria as initial presentation in a girl with factor VIII and factor IX inhibitors associated with systemic lupus erythematosus |journal=J. Pediatr. Hematol. Oncol. |volume=34 |issue=8 |pages=e344–5 |date=November 2012 |pmid=23018565 |doi=10.1097/MPH.0b013e3182678ec1 |url=}}</ref>
* A rash may be present
*[[Pallor]]<ref name="pmid9629545">{{cite journal |vauthors=Ries M, Klinge J, Rauch R, Chen C, Deeg KH |title=[Spontaneous subdural hematoma in a 18-day-old male newborn infant with severe hemophilia A] |language=German |journal=Klin Padiatr |volume=210 |issue=3 |pages=120–4 |date=1998 |pmid=9629545 |doi=10.1055/s-2008-1043862 |url=}}</ref><ref name="pmid22503263">{{cite journal |vauthors=Anjay MA, Sasidharan CK, Anoop P |title=Hepatic subcapsular hematoma: two neonates with disparate presentations |journal=Pediatr Neonatol |volume=53 |issue=2 |pages=144–6 |date=April 2012 |pmid=22503263 |doi=10.1016/j.pedneo.2012.01.013 |url=}}</ref>
* [[Pallor]] may be present
*[[Bruise|Bruises]]<ref name="pmid30129541">{{cite journal |vauthors=Sachdeva A, Gunasekaran V, Ramya HN, Dass J, Kotwal J, Seth T, Das S, Garg K, Kalra M, Sirisha RS, Prakash A |title=Consensus Statement of the Indian Academy of Pediatrics in Diagnosis and Management of Hemophilia |journal=Indian Pediatr |volume=55 |issue=7 |pages=582–590 |date=July 2018 |pmid=30129541 |doi= |url=}}</ref>
* Lesions may be present
===HEENT===
 
*HEENT examination of [[Patient|patients]] with hemophilia is usually normal.
<gallery widths=150px>
*Findings related to the [[Complication (medicine)|complications]] may include:
 
:*[[Pupil|Pupillary]] changes<ref name="pmid22385799">{{cite journal |vauthors=Peltier J, Baroncini M, Thines L, Leteurtre S, Marey A, Vinchon M |title=[Haemophilia A and intracranial bleedings in infants] |language=French |journal=Neurochirurgie |volume=58 |issue=1 |pages=19–24 |date=February 2012 |pmid=22385799 |doi=10.1016/j.neuchi.2012.01.003 |url=}}</ref>
UploadedImage-01.jpg | Description {{dermref}}
:*Bulging tense [[fontanelle]] in [[Infant|infants]]<ref name="pmid29848541">{{cite journal |vauthors=Bhattacharya D, Sharawat IK, Saini L |title=Intraventricular haemorrhage and obstructive hydrocephalus in a term neonate: an uncommon presentation of haemophilia B |journal=BMJ Case Rep |volume=2018 |issue= |pages= |date=May 2018 |pmid=29848541 |doi=10.1136/bcr-2018-225341 |url=}}</ref>
UploadedImage-02.jpg | Description {{dermref}}
:*[[Bruise|Bruises]]
 
:*[[Respiratory failure|Respiratory distress]]<ref name="pmid30246038">{{cite journal |vauthors=Moreira A, Das H |title=Acute Life-Threatening Hemorrhage in Neonates With Severe Hemophilia A: A Report of 3 Cases |journal=J Investig Med High Impact Case Rep |volume=6 |issue= |pages=2324709618800349 |date=2018 |pmid=30246038 |pmc=6144491 |doi=10.1177/2324709618800349 |url=}}</ref>
</gallery>
 
===Head===
* Abnormalities of the head/hair may include ___
* There may be evidence of trauma
 
===Eyes===
*Icteric sclera may be present
* [[Nystagmus]] may be present.
* Extra-ocular movements may be abnormal
*Pupils may not react to light
*Ophthalmoscopic exam may be abnormal with findings of ___
 
===Ears===
* Hearing acuity may be reduced
*[[Weber test]] may be positive
*[[Rinne test]] may be positive
* There may be [[exudate]] from the ear canal
* There may be [[tenderness]] on movement of the pinnae
 
===Nose===
* Nares may be inflamed
* There may be [[epistaxis]]
* There may be [[purulent]] exudate from the nares
* There may be [[tenderness]] to percussion of the sinuses
* The nares may be congested
 
===Throat===
* The throat may be erythematous
* There may be [[exudate]] in the throat
* There may be [[petechiae]] seen in the throat
* There may be tonsillar inflammation
 
===Neck===
===Neck===
*[[Jugular venous pressure]] may be elevated
*[[Edema|Swelling]]<ref name="pmid14414970">{{cite journal |vauthors=LEATHERDALE RA |title=Respiratory obstruction in haemophilic patients |journal=Br Med J |volume=1 |issue=5182 |pages=1316–20 |date=April 1960 |pmid=14414970 |pmc=1967523 |doi= |url=}}</ref>
*[[Carotid bruits]] may be present
*[[Bruise|Bruising]]<ref name="pmid14414970">{{cite journal |vauthors=LEATHERDALE RA |title=Respiratory obstruction in haemophilic patients |journal=Br Med J |volume=1 |issue=5182 |pages=1316–20 |date=April 1960 |pmid=14414970 |pmc=1967523 |doi= |url=}}</ref>
*[[Lymph nodes]] may be present
*[[Thyromegaly]] may be present
*[[Hepatojugular reflux]] may be present
 
===Lungs===
===Lungs===
*[[Pulmonary edema]] and [[rales]] may be present
[[Lung|Pulmonary]] examination of [[Patient|patients]] with hemophilia is usually normal.
*[[Wheezing]] may be present
*Consolidation may be present with reduced breath sounds auscultated
*[[Rales]] may be present
*[[Egophony]] may be present
* Chest movement may be assymetric
 
===Heart===
===Heart===
*A [[heave]] may be present
[[Circulatory system|Cardiovascular]] examination of [[Patient|patients]] with hemophilia is usually normal.
*A [[thrill]] may be present
*A [[friction rub]] may be pressent
 
====Auscultation====
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|Gallops]]
*A [[systolic murmur]] best heard at the base may be present
*A [[systolic murmur]] best heard at the apex may be present
*A [[diastolic murmur]] may be present
 
===Abdomen===
===Abdomen===
*[[Abdominal distention]] may be present
*[[Abdominal examination]] of [[Patient|patients]] with hemophilia is usually normal.
*[[Abdominal tenderness]] may be present
*Findings related to the [[Complication (medicine)|complications]] may include:
*[[Rebound tenderness]] may be present
:*[[Abdominal distension]]<ref name="pmid26261394">{{cite journal |vauthors=Delibegovic M, Alispahic A, Gazija J, Mehmedovic Z, Mehmedovic M |title=Intramural Haemorrhage and Haematoma as the Cause of Ileus of the Small Intestine in a Haemophiliac |journal=Med Arch |volume=69 |issue=3 |pages=206–7 |date=June 2015 |pmid=26261394 |pmc=4500296 |doi=10.5455/medarh.2015.69.206-207 |url=}}</ref><ref name="pmid22503263">{{cite journal |vauthors=Anjay MA, Sasidharan CK, Anoop P |title=Hepatic subcapsular hematoma: two neonates with disparate presentations |journal=Pediatr Neonatol |volume=53 |issue=2 |pages=144–6 |date=April 2012 |pmid=22503263 |doi=10.1016/j.pedneo.2012.01.013 |url=}}</ref>
*An [[acute abdomen]] may be present
:*[[Shifting dullness]]<ref name="pmid21127694">{{cite journal |vauthors=Eleftheriadis N, Makris P |title=Portal vein thrombosis in a patient with HCV cirrhosis and combined hemophilia A and thrombophilia V Leiden |journal=Ther Clin Risk Manag |volume=6 |issue= |pages=539–41 |date=October 2010 |pmid=21127694 |pmc=2988613 |doi=10.2147/TCRM.S13660 |url=}}</ref>
*An abdominal mass may be present
:*Vague [[pain]] and [[Abdominal fullness|fullness]]<ref name="pmid26261394">{{cite journal |vauthors=Delibegovic M, Alispahic A, Gazija J, Mehmedovic Z, Mehmedovic M |title=Intramural Haemorrhage and Haematoma as the Cause of Ileus of the Small Intestine in a Haemophiliac |journal=Med Arch |volume=69 |issue=3 |pages=206–7 |date=June 2015 |pmid=26261394 |pmc=4500296 |doi=10.5455/medarh.2015.69.206-207 |url=}}</ref><ref name="pmid9872546">{{cite journal |vauthors=Onda M, Urazumi K, Abe R, Matsuo K |title=Obstructive Ileus caused by blood clot after emergency total gastrectomy in a patient with hemophilia A: report of a case |journal=Surg. Today |volume=28 |issue=12 |pages=1266–9 |date=1998 |pmid=9872546 |doi=10.1007/BF02482812 |url=}}</ref>
*Guarding may be present
===Back===
*[[Hepatomegaly]] may be present
[[Human back|Back]] examination in [[Patient|patients]] with hemophilia is usually normal.
*[[Splenomegaly]] may be present
===Genitourinary===
*Genitourinary exam if relevant
[[Genitourinary system|Genitourinary]] examination in [[Patient|patients]] with hemophilia is usually normal.
 
===Neuromuscular===
Neuromuscular examination of [[Patient|patients]] with hemophilia is usually normal.
===Extremities===
===Extremities===
*[[Clubbing]] may be present
*[[Edema|Swelling]]<ref name="pmid24914744">{{cite journal |vauthors=De la Corte-Rodriguez H, Rodriguez-Merchan EC |title=Treatment of muscle haematomas in haemophiliacs with special emphasis on percutaneous drainage |journal=Blood Coagul. Fibrinolysis |volume=25 |issue=8 |pages=787–94 |date=December 2014 |pmid=24914744 |doi=10.1097/MBC.0000000000000159 |url=}}</ref><ref>{{cite book | last = Peterson | first = Lars | title = Sports injuries : their prevention and treatment | publisher = Martin Dunitz | location = London | year = 2001 | isbn = 0203419561 }}</ref><ref name="pmid27853081">{{cite journal |vauthors=Tsuyama N, Ichiba T, Naito H |title=Unusual Initial Manifestation of Acquired Hemophilia A: A Normal Activated Partial Thromboplastin Time, Intramuscular Hematoma and Cerebral Hemorrhage |journal=Intern. Med. |volume=55 |issue=22 |pages=3347–3349 |date=2016 |pmid=27853081 |pmc=5173506 |doi=10.2169/internalmedicine.55.7219 |url=}}</ref><ref name="PitcherBowley2002">{{cite journal|last1=Pitcher|first1=G. J.|last2=Bowley|first2=D. M. G.|last3=Chasumba|first3=G.|last4=Zuckerman|first4=M.|title=Life-threatening haemorrhage from a gastric Dieulafoy lesion in a child with haemophilia|journal=Haemophilia|volume=8|issue=5|year=2002|pages=719–720|issn=1351-8216|doi=10.1046/j.1365-2516.2002.00675.x}}</ref>
*[[Cyanosis]] may be present
*[[Tenderness]]<ref name="BerntorpShapiro2012">{{cite journal|last1=Berntorp|first1=Erik|last2=Shapiro|first2=Amy D|title=Modern haemophilia care|journal=The Lancet|volume=379|issue=9824|year=2012|pages=1447–1456|issn=01406736|doi=10.1016/S0140-6736(11)61139-2}}</ref><ref name="FranchiniMannucci2013">{{cite journal|last1=Franchini|first1=Massimo|last2=Mannucci|first2=Pier Mannuccio|title=Hemophilia A in the third millennium|journal=Blood Reviews|volume=27|issue=4|year=2013|pages=179–184|issn=0268960X|doi=10.1016/j.blre.2013.06.002}}</ref><ref name="pmid26733762">{{cite journal |vauthors=Goto M, Takedani H, Nitta O, Kawama K |title=Joint Function and Arthropathy Severity in Patients with Hemophilia |journal=J Jpn Phys Ther Assoc |volume=18 |issue=1 |pages=15–22 |date=2015 |pmid=26733762 |doi=10.1298/jjpta.18.15 |url=}}</ref><ref name="pmid27073678">{{cite journal |vauthors=Arpaci T, Sasmaz I, Akbas T, Eken A, Ozgur A, Antmen B |title=Bilateral recurrent external obturator muscle hematoma: An unusual cause of pelvic pain in hemophilia |journal=Mol Clin Oncol |volume=4 |issue=4 |pages=622–624 |date=April 2016 |pmid=27073678 |pmc=4812266 |doi=10.3892/mco.2016.736 |url=}}</ref><ref name="pmid26733762">{{cite journal |vauthors=Goto M, Takedani H, Nitta O, Kawama K |title=Joint Function and Arthropathy Severity in Patients with Hemophilia |journal=J Jpn Phys Ther Assoc |volume=18 |issue=1 |pages=15–22 |date=2015 |pmid=26733762 |doi=10.1298/jjpta.18.15 |url=}}</ref>
*[[Edema]] may be present
 
===Neurologic===
* Mental status may be altered
* Glasgow coma scale is ___
* Clonus may be present
* Hyperactive reflexes may be present
* There are deficits in cranial nerves ___
 
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 20:02, 21 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

Patients with hemophilia usually appear normal. Physical examination of patients with hemophilia is usually remarkable for tachycardia, pallor, bruising, abdominal pain and distension, hypotension, and muscle or joint swelling.

Physical Examination

Physical examination of patients with hemophilia is usually remarkable for tachycardia, pallor, hypotension, and muscle or joint swelling.[1][2][3][4][5]

Appearance of the Patient

Patients with hemophilia usually appear normal.

Vital Signs

Skin

HEENT

  • HEENT examination of patients with hemophilia is usually normal.
  • Findings related to the complications may include:

Neck

Lungs

Pulmonary examination of patients with hemophilia is usually normal.

Heart

Cardiovascular examination of patients with hemophilia is usually normal.

Abdomen

Back

Back examination in patients with hemophilia is usually normal.

Genitourinary

Genitourinary examination in patients with hemophilia is usually normal.

Neuromuscular

Neuromuscular examination of patients with hemophilia is usually normal.

Extremities

References

  1. ↑ 1.0 1.1 1.2 Pham TV, Sorenson CA, Nable JV (February 2014). "Acquired factor VIII deficiency presenting with compartment syndrome". Am J Emerg Med. 32 (2): 195.e1–2. doi:10.1016/j.ajem.2013.09.022. PMID 24176587.
  2. ↑ 2.0 2.1 De la Corte-Rodriguez H, Rodriguez-Merchan EC (December 2014). "Treatment of muscle haematomas in haemophiliacs with special emphasis on percutaneous drainage". Blood Coagul. Fibrinolysis. 25 (8): 787–94. doi:10.1097/MBC.0000000000000159. PMID 24914744.
  3. ↑ Peterson, Lars (2001). Sports injuries : their prevention and treatment. London: Martin Dunitz. ISBN 0203419561.
  4. ↑ 4.0 4.1 Tsuyama N, Ichiba T, Naito H (2016). "Unusual Initial Manifestation of Acquired Hemophilia A: A Normal Activated Partial Thromboplastin Time, Intramuscular Hematoma and Cerebral Hemorrhage". Intern. Med. 55 (22): 3347–3349. doi:10.2169/internalmedicine.55.7219. PMC 5173506. PMID 27853081.
  5. ↑ 5.0 5.1 Pitcher, G. J.; Bowley, D. M. G.; Chasumba, G.; Zuckerman, M. (2002). "Life-threatening haemorrhage from a gastric Dieulafoy lesion in a child with haemophilia". Haemophilia. 8 (5): 719–720. doi:10.1046/j.1365-2516.2002.00675.x. ISSN 1351-8216.
  6. ↑ DeWitt ES, DiMichele DM, Larsen K, Pass RH (July 2010). "Successful cryoablation of atrioventricular nodal reentrant tachycardia in a child with hemophilia A". J. Pediatr. Hematol. Oncol. 32 (5): 404–6. doi:10.1097/MPH.0b013e3181e0040d. PMID 20505535.
  7. ↑ 7.0 7.1 Peltier J, Baroncini M, Thines L, Leteurtre S, Marey A, Vinchon M (February 2012). "[Haemophilia A and intracranial bleedings in infants]". Neurochirurgie (in French). 58 (1): 19–24. doi:10.1016/j.neuchi.2012.01.003. PMID 22385799.
  8. ↑ 8.0 8.1 Franchini, Massimo; Mannucci, Pier Mannuccio (2013). "Hemophilia A in the third millennium". Blood Reviews. 27 (4): 179–184. doi:10.1016/j.blre.2013.06.002. ISSN 0268-960X.
  9. ↑ Shen CY, Fu LS, Lin HK, Han SM, Wang JD (November 2012). "Macrohematuria as initial presentation in a girl with factor VIII and factor IX inhibitors associated with systemic lupus erythematosus". J. Pediatr. Hematol. Oncol. 34 (8): e344–5. doi:10.1097/MPH.0b013e3182678ec1. PMID 23018565.
  10. ↑ Ries M, Klinge J, Rauch R, Chen C, Deeg KH (1998). "[Spontaneous subdural hematoma in a 18-day-old male newborn infant with severe hemophilia A]". Klin Padiatr (in German). 210 (3): 120–4. doi:10.1055/s-2008-1043862. PMID 9629545.
  11. ↑ 11.0 11.1 Anjay MA, Sasidharan CK, Anoop P (April 2012). "Hepatic subcapsular hematoma: two neonates with disparate presentations". Pediatr Neonatol. 53 (2): 144–6. doi:10.1016/j.pedneo.2012.01.013. PMID 22503263.
  12. ↑ Sachdeva A, Gunasekaran V, Ramya HN, Dass J, Kotwal J, Seth T, Das S, Garg K, Kalra M, Sirisha RS, Prakash A (July 2018). "Consensus Statement of the Indian Academy of Pediatrics in Diagnosis and Management of Hemophilia". Indian Pediatr. 55 (7): 582–590. PMID 30129541.
  13. ↑ Bhattacharya D, Sharawat IK, Saini L (May 2018). "Intraventricular haemorrhage and obstructive hydrocephalus in a term neonate: an uncommon presentation of haemophilia B". BMJ Case Rep. 2018. doi:10.1136/bcr-2018-225341. PMID 29848541.
  14. ↑ Moreira A, Das H (2018). "Acute Life-Threatening Hemorrhage in Neonates With Severe Hemophilia A: A Report of 3 Cases". J Investig Med High Impact Case Rep. 6: 2324709618800349. doi:10.1177/2324709618800349. PMC 6144491. PMID 30246038.
  15. ↑ 15.0 15.1 LEATHERDALE RA (April 1960). "Respiratory obstruction in haemophilic patients". Br Med J. 1 (5182): 1316–20. PMC 1967523. PMID 14414970.
  16. ↑ 16.0 16.1 Delibegovic M, Alispahic A, Gazija J, Mehmedovic Z, Mehmedovic M (June 2015). "Intramural Haemorrhage and Haematoma as the Cause of Ileus of the Small Intestine in a Haemophiliac". Med Arch. 69 (3): 206–7. doi:10.5455/medarh.2015.69.206-207. PMC 4500296. PMID 26261394.
  17. ↑ Eleftheriadis N, Makris P (October 2010). "Portal vein thrombosis in a patient with HCV cirrhosis and combined hemophilia A and thrombophilia V Leiden". Ther Clin Risk Manag. 6: 539–41. doi:10.2147/TCRM.S13660. PMC 2988613. PMID 21127694.
  18. ↑ Onda M, Urazumi K, Abe R, Matsuo K (1998). "Obstructive Ileus caused by blood clot after emergency total gastrectomy in a patient with hemophilia A: report of a case". Surg. Today. 28 (12): 1266–9. doi:10.1007/BF02482812. PMID 9872546.
  19. ↑ Peterson, Lars (2001). Sports injuries : their prevention and treatment. London: Martin Dunitz. ISBN 0203419561.
  20. ↑ Berntorp, Erik; Shapiro, Amy D (2012). "Modern haemophilia care". The Lancet. 379 (9824): 1447–1456. doi:10.1016/S0140-6736(11)61139-2. ISSN 0140-6736.
  21. ↑ 21.0 21.1 Goto M, Takedani H, Nitta O, Kawama K (2015). "Joint Function and Arthropathy Severity in Patients with Hemophilia". J Jpn Phys Ther Assoc. 18 (1): 15–22. doi:10.1298/jjpta.18.15. PMID 26733762.
  22. ↑ Arpaci T, Sasmaz I, Akbas T, Eken A, Ozgur A, Antmen B (April 2016). "Bilateral recurrent external obturator muscle hematoma: An unusual cause of pelvic pain in hemophilia". Mol Clin Oncol. 4 (4): 622–624. doi:10.3892/mco.2016.736. PMC 4812266. PMID 27073678.

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