Vol.102 No.8 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 102 No. 8 August 2009
Facial Bone Fracture in a Patient with Previously Undiagnosed Hemophilia
Masahiro Nakayama
(Tsukuba University Hospital)
Keiji Tabuchi, Hideki Okubo and Akira Hara
(Graduate School of Comprehensive Human Sciences, University of Tsukuba)
Kenji Machiki
(Hitachi, Ltd. Mito General Hospital)
Hemophilia A is an X-linked hereditary disease. We describe herein a patient with multiple fractures of the facial bones, who was diagnosed with hemophilia A during treatment. A 15-year-old boy presented with multiple fractures of the facial bones at Hitachi, Ltd. Mito General Hospital. He underwent a repair operation for the fractures. Severe epistaxis recurred after the operation, and he was referred to Tsukuba University Hospital for further evaluation and treatment. On admission, laboratory testing revealed prolonged activated partial thromboplastin times (APTT) and decreased activity of factor VIII, which led to a diagnosis of hemophilia A. Administration of a coagulation factor VIII product prevented bleeding. The clinical phenotype is not always the same among hemophilia patients, thus, the possibility of previously undetected hemophilia has to be considered when treating unexpected severe bleeding.
Key words :facial bones fracture, hemophilia A, APTT, coagulation factor VIII product