Hemophiliacs--a picture from a developing country: Karnataka, a south Indian state

Forty cases of hereditary bleeding disorders, who are the members of Karnataka Hemophilia Society (a State Chapter of the Hemophilia Federation of India) were studied to learn their problems. Twenty-four cases were thoroughly investigated including factor assay and in 16 cases the diagnosis was based on classical clinical presentation and pattern of inheritance. There were 16 cases of hemophilia A, 3 cases of hemophilia B, 2 cases of von Willebrand's disease, 1 case of factor XIII deficiency and 2 cases of hereditary afibrinogenemia. The age group varied from 3 months to 36 years; 39 were male. The age of onset of symptoms, type of bleeding, type of joints involved, disabilities experienced by these patients, severity of the disorder, presence of antibodies to factor, presence of HBsAg and HIV, the availability of treatment for these patients, treatment received and the financial burden faced by these patients were studied. Thirty-three cases (82.5%) had joint bleeds, 60% of the patients experienced various type of disabilities, 11 (27.5%) had epistaxis, 10 (25%) had GI bleeds, 5 (12.5%) had dental bleeding, 8 (20%) had haematomas, 3 (7.5%) had umbilical stump bleeds and 19 cases (47.5%) had previous blood transfusions.