بررسي ميزان شيوع و شدت آرتروپاتي در بيماران هموفيليك مراجعه كننده به مركز هموفيلي بيمارستان شفا

Assessment of prevalence and severity of hemophilic arthropathy in hemophilic patients referring to Ahwaz Shafa hospital Hemophilia center

Objective: The most common presentation of severe hemophilia is the hemarthrosis that can lead to severe and permanent morbidities. This study was performed to assess the condition of joints of Hemophilic patients who routinely refer to our Shafaʹs hospital and to determine the amount of factor 8 consumption over one year in relation to age, severity of their disease and degree of joint involvement. In addition, to compare of these findings with similar studies in other countries. Subjects and Methods: In this study, hemophilic patients were visited and examined for the number of involved joints and their severity of arthropaty on Gilbertʹs scale. The amount of factor 8 consumption for each patient was computed from their record. Clinical findings from patientsʹ examination and their records were processed for obtaining the frequency tables for their age, type and severity of hemophilia and also for number and severity of joints involvement and mean annual factor consumption. Results: A total of 138 cases were assessed in this study (mean age 21.8 years), 112 of these cases (81 %) had type A, 26 cases (19%) type B hemophilia. In terms of severity of the disease 97 case (70%) were severe, 26 cases (19%) moderate and 15 cases (11%) had mild form of the disease. The mean of the number of joint involvement was 3.43 and the mean of physical examination of joints on Gilbertʹs scale was 14.6, and for severe form this was 17.9. Knee was the most involved joint (113 case). The mean of factor 8 consumed over one year for type A was 38770 IU and for type B was 23562 IU. Conclusion: The mean Gilbertʹs scale was higher than reported in similar studies in France and Spain. However, the mean factor consumption over year was lower. The finding of this study suggests that the control of Hemarthrosis as well as its out come in our patients is not good. Lacking a proper prophylactic or curative policy for these patients can lead to a huge economic burden for our health system.