title: Combined clotting factor deficiencies: experience at a single hemophilia treatment center.
abstract: We describe a series of patients with combined factor deficiencies and von Willebrand's disease (VWD) at one haemophilia treatment centre. Although the incidence of VWD is at least 1% in the general population, combined coagulation defects have been infrequently described in the medical literature and are likely under diagnosed. This entity should be considered in patients with a known factor deficiency and either an unexpectedly severe bleeding phenotype, or bleeding that is unresponsive to factor replacement.
authors.affiliation: Division of Pediatric Hematology/Oncology, Columbus Children's Hospital, Columbus, OH 43205, USA. sarah.obrien@chp.edu
authors.forename: S H
authors.initials: SH
authors.lastname: O'Brien
authors.forename: A K
authors.initials: AK
authors.lastname: Ritchey
authors.forename: M V
authors.initials: MV
authors.lastname: Ragni
mesh_terms: D000328:Adult; D001760:Bleeding Time; D025861:Blood Coagulation Disorders, Inherited / Q000097:blood / Q000150:complications*; D002675:Child, Preschool; D005164:Factor IX / Q000032:analysis; D005169:Factor VIII / Q000032:analysis; D006470:Hemorrhage / Q000097:blood / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014842:von Willebrand Diseases / Q000097:blood / Q000150:complications*; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D014841:von Willebrand Factor; D005169:Factor VIII; D005164:Factor IX