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Symptoms

By Mayo Clinic staff

Signs and symptoms of hemophilia vary depending on how deficient you are in clot-forming proteins called clotting factors. If levels of your deficient clotting factor are very low, you may experience spontaneous bleeding. If levels of your deficient clotting factor are slightly to moderately low, you may bleed only after surgery or trauma.

Signs and symptoms of spontaneous bleeding may include:

  • Many large or deep bruises
  • Joint pain and swelling caused by internal bleeding
  • Unexplained and excessive bleeding or bruising
  • Blood in your urine or stool
  • Prolonged bleeding from cuts or injuries or after surgery or tooth extraction
  • Nosebleeds without a known cause
  • Tightness in your joints
  • In infants, unexplained irritability
  • Unusual bleeding after immunizations

Emergency signs and symptoms of hemophilia may include:

  • Sudden pain, swelling, and warmth of large joints, such as knees, elbows, hips and shoulders, and of the muscles of your arms and legs
  • Bleeding from an injury, especially if you have a severe form of hemophilia
  • Painful, lasting headache
  • Repeated vomiting
  • Extreme fatigue
  • Neck pain
  • Double vision

Babies with hemophilia
At first, because of limited mobility, a baby with hemophilia usually won't have many problems related to hemophilia. But as your baby begins to move around, falling and bumping into things, superficial bruises may occur. This bleeding into soft tissue may become more frequent the more active your child becomes.

When to see a doctor
If you're pregnant or considering a pregnancy and have a family history of hemophilia, talk to your doctor. You may be referred to a medical genetics specialist or a specialist in bleeding disorders, who can help you determine if you are a carrier of hemophilia. If you are a carrier, it's possible to test the fetus during pregnancy to determine if it is affected by the disease.

If you have a baby boy, prolonged bleeding following circumcision may be the first indication of hemophilia. In girls and in boys who aren't circumcised, easy bruising when the child becomes more mobile may lead to the diagnosis. The first episode of bleeding generally occurs by the time a child is 2 years old. If your baby bruises easily as he or she becomes more mobile, see your doctor.

References
  1. Hoots KW, et al. Clinical manifestations and diagnosis of hemophilia. http://www.uptodate.com/home/index.html. Accessed June 25, 2011.
  2. Hemophilia. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec11/ch136/ch136c.html#sec11-ch136-ch136d-524. Accessed June 25, 2011.
  3. Hemophilia. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/hemophilia/hemophilia_all.html. Accessed June 25, 2011.
  4. Hemophilia facts. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/hemophilia/facts.html. Accessed June 25, 2011.
  5. Factor XI deficiency. National Hemophilia Foundation. http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=54&contentid=54. Accessed June 27, 2011.
  6. Rodriguez NI, et al. Advances in hemophilia: Experimental aspects and therapy. Hematology and Oncology Clinics of North America. 2010; 24:181.
  7. Care at comprehensive treatment centers can save lives. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/Features/ComprehensiveCare. Accessed June 25, 2011.
DS00218 Aug. 31, 2011

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