New house or new limbs?!
We describe a rare case of end-stage haemophiliac joint disease with inhibitors to factor VIII. Using recombinant factor VIIa treatment, the patient was able to undergo major orthopaedic procedures not previously possible. Although the estimated cost of putting this patient through surgery, prosthetic fitting and rehabilitation is close to pound 500,000, we hope his overall care requirements will be reduced following the successful surgery and that he will require considerably less in the way of analgesics with an improved independent quality of life for many years.
East Kent NHS Trust, Kent, UK. iheanyi@doctors.net.uk
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Nwachuku
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Obi
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Housden
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Winter
D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D019774:Blood Coagulation Factor Inhibitors / Q000097:blood; D005169:Factor VIII / Q000276:immunology; D015942:Factor VIIa / Q000627:therapeutic use; D006395:Hemarthrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D006488:Hemostasis, Surgical / Q000379:methods; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000191:economics / Q000379:methods*; D011859:Radiography; D011994:Recombinant Proteins / Q000627:therapeutic use
D019774:Blood Coagulation Factor Inhibitors; D011994:Recombinant Proteins; D005169:Factor VIII; C103587:recombinant FVIIa; D015942:Factor VIIa