Hematology Center
Hemophilia

Home

Bleeding Patient
Reversing Coumadin
Reversing Heparin
Laboratory Tests in Hematology
Laboratory Tests In Coagulation
Aceruloplasminemia
African Iron Overload
Anemia, microcytic
Antiphospholipid Syndrome
Anemia, Microcytic, real cases
ATIII Deficiency
Atransferrinemia
Aplastic Anemia
B12 deficiency
Basophilia
Coagulation and Cancer
DIC
Essential Thrombocytosis
ENZYME DISORDERS (RBC)
Eosinophilia
Folate Deficiency
Hemoglobinoapthies
Hemoglobin S/C
Hemoglobin S/S
Hemolytic Anemia
Hemochromatosis
Hemophilia
Hemostasis
Heparins
Heparin-induced thrombocytopenia
Hypercoagulable States
Hyper-Ferritinemia
ITP
Iron Chelation
IRON DEFICIENCY
IRON OVERLOAD
IRON STUDIES
Liver and hemostasis
Megaloblastic Anemia
Monocytosis
Myleofibrosis with Myeloid Metaplasia
Neutrophil Structure
vWF
Porphyria
Phorphyrias (AIP)
Phorphyrias (AIP)
Polycythemia Vera
Prothrombin 20210A
RBC Membrane Disorders
Sickle Cell
Sideroblastic Anemias
Syndromes
TTP
Thalassemia
Thrombocytopenia, congenital
Wilson's Disease
Immunological markers
Amicar
Anagrelide
Oral Anticoagulants
Refludan

1. Treatment of Specific Hemorrhages in Hemophilia
2. Calculation of Doses

Hemarthrosis
*** Hemophilia A- 20 U/Kg factor VIII concentrate; 15 U/Kg if treated early; repeat dose the following day if severe bleed.
*** Hemophilia B- 30 U/Kg factor IX concentrate; 20 U/Kg if treated early
____________________________________________
Muscle or subcutaneous hematoma:
*** Hemophilia A- 20 U/Kg factor VIII concentrate; Q48 hr until well controlled.
*** Hemophilia B- 30 U/Kg factor IX concentrate. May need Q2-3 d treatment until well controlled
____________________________________________
Epistaxis
*** Hemophilia A
20 U/Kg factor VIII concentrate if other measures fail
*** Hemophilia B
30 U/Kg factor IX concentrate if other measures fail
NOTE: need to try antifibrinolytic therapy first.
____________________________________________
Major surgery or life threatening hemorrhage
*** Hemophilia A- 50 U/Kg factor VIII concentrate, followed by 25 U/Kg Q12 (or C.I.) to maintain factor VIII level above 50 U/Dl for 5-7 days & then to maintain factor VIII level above 30 U/Dl for 5-7 days
*** Hemophilia B-
80 U/Kg factor IX concentrate followed by 20-40 U/Kg Q12-24 hr to maintain factor level above 40 U/Dl for 5-7 days then to maintain factor level above 30 U/dl for 5-7 days
____________________________________________
Ileopsoas Hemorrhage
Hemophilia A- 50 U/Kg factor VIII concentrate followed by 25 U/Kg until symptoms relieved then 20 U Q 48 hr for 10-14 days
Hemophilia B- 80 U/Kg factor IX concecntrate then20-40 U/Kg Q12-24 hrs to maintain levels above 40 U/dl until asymptomatic then 30 U Q 48 hours for 10-14 days
____________________________________________
Hematuria
Hemophilia A- If other measures fail in 48 hours then try 20 U/Kg factor VIII concentrate
(may try prednisone)
Hemophilia B- If other measures fail then try 30 U/Kg factor IX concentrate
(may try prednisone)
____________________________________________

Calculation of doses
----------------------------
Hemophilia A:
Dose needed(U)=% desired rise plasma factor VIII X Body Weight (Kg) X 0.5

Hemophilia B:
Dose needed (IU) = % desired rise X Body Weight (Kg)