Bleeding Disorder Diagnosis in Children: Back-to-School Edition

Hemophilia and other bleeding disorders are conditions that affect the blood’s ability to clot. People with hemophilia have low levels or lack of certain proteins called clotting factors, which help stop bleeding when an injury occurs. Without enough clotting factors, people with hemophilia and other bleeding disorders can bleed long after a cut, bruise, surgery, or dental procedure. They can also have internal bleeding in their joints, muscles, or organs, which can cause pain, swelling, and damage. 

Diagnosing Hemophilia 

Hemophilia is an inherited condition caused by gene mutations that affect the production of clotting factors. The genes responsible for producing factor VIII and factor IX are on the X chromosome. As a result, hemophilia predominantly affects males, as they have one X and one Y chromosome.  

If a boy inherits an X chromosome with the hemophilia gene from his mother, he will have hemophilia. If a girl inherits an X chromosome with the hemophilia gene from either parent, she will be a carrier and may have mild symptoms or pass it on to her children.  

Although hemophilia is typically inherited, about one-third of cases are caused by a new mutation in the gene that makes clotting factors. 

To diagnose hemophilia in children, healthcare professionals employ a variety of tests to measure the levels and activity of clotting factors in the blood. These tests help determine the specific type and severity of hemophilia and guide appropriate treatment strategies. 

Complete Blood Count (CBC) 

A complete blood count is a routine blood test that provides information about the number of blood cells present, including red blood cells, white blood cells, and platelets. While a CBC cannot directly diagnose hemophilia, it helps identify abnormalities that may suggest a bleeding disorder. 

Prothrombin Time (PT) and Activated Partial Thromboplastin Time (PTT) 

The PT and PTT tests evaluate the clotting ability of the blood. PT measures the time it takes for blood to clot, primarily assessing the extrinsic pathway of coagulation. PTT measures the time it takes for blood to clot through the intrinsic pathway. Prolonged PT and PTT results may indicate a clotting factor deficiency, pointing to the possibility of hemophilia. 

Factor VIII and Factor IX Activity Tests 

Factor VIII and Factor IX activity tests specifically measure the levels and functionality of these clotting factors in the blood. These tests help determine the type and severity of hemophilia. Lower levels of factor VIII indicate hemophilia A, while reduced factor IX levels indicate hemophilia B. 

Genetic Testing 

Genetic testing can confirm the presence of specific gene mutations associated with hemophilia. This testing is particularly useful in cases where family history suggests a genetic predisposition to the condition. Genetic testing can help identify carriers and provide information about the likelihood of passing the gene mutation to future generations. 

Prenatal Testing 

Prenatal testing can be performed during pregnancy to determine if the fetus has hemophilia. Two common prenatal testing methods include amniocentesis, which involves the removal of amniotic fluid for analysis, and chorionic villus sampling (CVS), which involves taking a placenta sample. These tests can provide valuable information about the presence and severity of hemophilia in the unborn child. 

Hemophilia is a lifelong condition that requires ongoing care and attention. But it does not have to stop your child from pursuing his or her dreams and aspirations. Your child can have a safe, healthy, and happy school year with proper treatment, education, communication, and support.