Pitfalls in the management of a child with mild haemophilia A and a traumatic hyphaema.
A 12-year-old boy presented with a traumatic hyphaema that failed to settle with the standard treatment. Subsequent investigation showed that despite a normal APTT, he had a low factor VIII:C. Treatment with DDAVP precipitated further bleeding despite correction of the fVIII:C to normal, possibly caused by the vasodilation induced by the therapy. Bleeding was effectively treated with recombinant fVIII concentrate. DDAVP may be contraindicated in mild Haemophilia and von Willebrand patients for treatment of traumatic hyphaema.
Hallet
C
C
Department of Ophthalmology, Royal Liverpool Children's Hospital, Liverpool, UK.
Willoughby
C
C
Shafiq
A
A
Kaye
S B
SB
Bolton-Maggs
P H
PH
D002648:Child; D000075202:Contraindications; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage / Q000009:adverse effects; D019468:Disease Management; D005169:Factor VIII / Q000008:administration & dosage / Q000378:metabolism; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy*; D006490:Hemostatics; D006801:Humans; D006988:Hyphema / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D010314:Partial Thromboplastin Time; D011994:Recombinant Proteins / Q000008:administration & dosage; D014947:Wounds and Injuries / Q000150:complications*
D006490:Hemostatics; D011994:Recombinant Proteins; D005169:Factor VIII; D003894:Deamino Arginine Vasopressin