The treatment for hemophilia, which is a genetic disease that alters the blood's clotting ability, is done by replacing the clotting factors that are deficient in the person, which is factor VIII, in the case of type A hemophilia, and the factor IX, in the case of type B hemophilia.
Coagulation factors are essential blood proteins that are activated when a blood vessel ruptures, so that bleeding is contained, so when they are replaced during treatment, they help the person with hemophilia to lead a normal life without many restrictions. To learn more about what causes and how to identify hemophilia, check out the myths and truths about hemophilia.
Types of treatment
Although there is no cure, the treatment of hemophilia helps to prevent bleeding from occurring frequently, and is guided by the hematologist, which can be done in two different ways:
- Preventive treatment: consists of periodic replacement of clotting factors, so that they are always with increased levels in the body, and prevent possible bleeding. This type of treatment may not be necessary in some cases of mild haemophilia, and treatment may be recommended only when there is some type of hemorrhage. Treatment after bleeding: it is the treatment on demand, done in all cases, with the application of the clotting factor concentrate when there is a bleeding episode, which allows it to be resolved more quickly.
In either treatment, doses should be calculated according to body weight, the severity of hemophilia and the levels of clotting factor activity that each person has in their blood. Factor VIII or IX concentrates are made available by the Ministry of Health, through SUS, and consist of an ampoule with powder that is diluted in distilled water for application.
In the past, treatment was done with blood transfusions, which is no longer necessary as a routine, but can be used in emergency situations or in the absence of injections of clotting factors.
In addition, other types of hemostatic agent concentrates can be used to aid coagulation, such as cryoprecipitate, prothrombin complex and desmopressin, for example. These treatments are performed free of charge by SUS, in the state's hematology centers, simply by being referred by the general practitioner or hematologist.
Treatment in cases of hemophilia with inhibitor
Some hemophiliacs may develop antibodies against the factor VIII or IX concentrate used for treatment, called inhibitors, which can impair the treatment response.
In these cases, it may be necessary to carry out a treatment with higher doses, or with the combination of other blood coagulant components.
Care during treatment
People with hemophilia should take the following precautions:
- Practice physical activities, to strengthen muscles and joints, reducing the chances of bleeding, however, you should avoid impact sports or violent physical contact; Observe the appearance of new symptoms, especially in children, and decrease with treatment; Always have medication nearby, especially if traveling; Have an identification, like a bracelet, indicating the disease, for emergency cases; Inform the condition whenever you do any procedure, such as vaccine application, dental surgery or medical procedures; Avoid medications that facilitate bleeding, such as aspirin, anti-inflammatories and anticoagulants, for example.
In addition, physiotherapy should also be part of the treatment of hemophilia because it improves motor function, decreasing the risk of complications, such as acute hemolytic synovitis, which is an inflammation of the joint due to bleeding, and improves muscle tone, and therefore this may even decrease the need for blood clotting factors and improve quality of life.
