Hemophilia in Iran

Dorgalaleh, A. and Dadashizadeh, G. and Bamedi, T. (2016) Hemophilia in Iran. Hematology, 21 (5). pp. 300-310.

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Abstract

Background: Hemophilia A (HA) and B (HB) are common bleeding disorders, Iran having the ninth largest such population in the world. A considerable number of studies have been performed on different aspects of their disorder. Objective: The aim of the study was to gather all obtainable data about Iranian patients with HA and HB, including molecular studies, clinical presentations and treatment, and development and management of patients with inhibitor, to help better understand the disease and its management in other parts of the world. Methods: For this review study, we searched MEDLINE and Scientific Information Database for English and Persian sources until 2015. Results and discussion: There are 5369 patients with HA and HB in Iran among which 4438 patients have HA. About one-fifth of HA patients’ genes were analyzed and their underlying defects detected. Hemarthrosis, epistaxis, ecchymosis, and post-dental extraction bleeding are the most common clinical presentations. Bleeding was mainly managed by on-demand replacement therapy with factor VIII/factor IX (FVIII/FIX) concentrates or cryoprecipitate in HA, and fresh frozen plasma in HB in the absence of factor concentrate. Mean per capita for FVIII in HA patients is 1.56 IU, which is higher than the global per capita mean. However, mean per capita for FIX (0.24 IU) is lower than the global mean but highest among eastern Mediterranean countries. Replacement with plasma-derived components has led to infection in a large number of patients as well as inhibitor development against exogenous infusion of coagulation factors. According to a World Federation of Hemophilia survey, 223 HA and 6 HB patients in Iran have developed inhibitor and have been mainly managed by recombinant FVII (rFVIIa) and activated prothrombin-complex concentrate. Conclusion: Although this study was performed in Iranian patients, the large number thereof gives confidence that the results can be used more widely for other countries, especially in the developing world. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

Item Type: Article
Additional Information: Cited By :14 Export Date: 16 February 2020 CODEN: HMATF Correspondence Address: Bamedi, T.; Genetics of Non-Communicable Disease Research Center, Zahedan University of Medical SciencesIran; email: hematology.1390@gmail.com
Uncontrolled Keywords: Clinical presentation Hemophilia Iran Management Molecular analysis blood clotting factor 8 blood clotting factor 9 fresh frozen plasma blood clotting factor blood clotting factor 7a F8 protein, human prothrombin complex concentrates Article bleeding bleeding time blood clotting test cryoprecipitate differential diagnosis ecchymosis epistaxis gel electrophoresis genetic analysis genetic variability health care cost health survey hemarthrosis hemophilia A hemophilia B hepatitis C hospitalization human infection risk missense mutation nerve compression partial thromboplastin time prenatal diagnosis prevalence priority journal prothrombin time quality of life thrombin time tooth extraction von Willebrand disease blood female genetics Hemorrhage male metabolism Blood Coagulation Factors Factor IX Factor VIIa Factor VIII Humans
Subjects: WH Hemic and Lymphatic System
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib4 lib4
Date Deposited: 03 Mar 2020 05:03
Last Modified: 03 Mar 2020 05:03
URI: http://eprints.mums.ac.ir/id/eprint/12969

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