A Case of Haemophilic Arthropathy Seen in UTH Morafeno Toamasina

Hoby Nomena Rakotomalala, Randriamampianina Tahianasoa, Rakotoarivelo Zolalalaina Hubertine, Ralandison Stéphane, Rakoto Alson Aimée Olivat


Introduction: Hemophilia is a hemorrhagic disease caused by congenital deficiency of factor VIII (hemophilia A) or factor IX (haemophilia B) coagulation. It is an inherited X-linked genetic inheritance disorder that affects mainly boys. Haemarthrosis is one of the common haemorrhagic signs of hemophilia, which could be complicated by advanced arthropathy that may affect the patient's functional prognosis. Our aim is to report through a case these rheumatologic complications of a haemophilia.

Observation: A 15-year-old boy with severe haemophilia, presenting recurrent hemarthrosis since the age of 10 years. He was seen for arthritis of the right knee which has deteriorated progressively over two years, with knee joint swelling, patellofemoral syndrome, an axial valgus deviation and a flessum of the knee, accompagnied by an amyotrophy of the quadriceps. Radiological examination showed stage III hemophilic arthropathy. He received substitution treatment with symptomatic treatments and physiotherapy.

Discussion and conclusion: Hemophilic arthropathy involves the functional prognosis of patients with severe hemophilia. Prophylactic replacement therapy has significantly decreased the frequency of advanced stages. However, in low-income countries, this prophylaxis is still limited because of the lack of accessibility and disponibility of replacement factor. There is a relatively broad therapeutic panel for the management of hemophilic arthropathy ranging from physiotherapy, to inflatrative procedures to surgery.


Hemophilia, rheumatologic complication, arthropathy, prophylaxis, replacement therapy

Full Text:



Alcalay M., Durand G. Manifestations musculaires, articulaires et osseuses de l’hémophilie. EMC (Elsevier Masson SAS, Paris), Appareil locomoteur, 14-280-A-10,2008.

Manco-Johnson M. J., Abshire T. C., Shapiro A. D. et al. Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. N Engl J Med. 2007; 357(6): 535 – 44.

Dobon M, Lucía J F , Aguilar C, et al . Value of magnetic resonance imaging for the diagnosis and follow-up of haemophilic arthropathy. Haemophilia. 2003;9(1): 76 – 85.

Pergantou H., Platokouki H., Matsinos G.et al. Assessment of the progression of haemophilic arthropathy in children. Haemophilia. 2010;16 (1):124 – 9.

Pasta G, et al. Synoviorthesis in haemophilia patients with inhibitors. Haemophilia. 2008 Nov;14 Suppl 6:52-5.

Westberg M et al. Haemophilic arthropathy: long-term outcomes in 107 primary total knee arthroplasties. Knee. 2014 Jan;21(1):147-50.

DOI: http://dx.doi.org/10.52155/ijpsat.v17.1.1376


  • There are currently no refbacks.

Copyright (c) 2019 Hoby Nomena Rakotomalala

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.