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Blood, 1 July 2006, Vol. 108, No. 1, pp. 52-56. Prepublished online as a Blood First Edition Paper on March 21, 2006; DOI 10.1182/blood-2005-09-3879. This Article Full Text (PDF) All Versions of this Article: 2005-09-3879v1 108/1/52    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Plug, I. Articles by Rosendaal, F. R Search for Related Content PubMed PubMed Citation Articles by Plug, I. Articles by Rosendaal, F. R Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted September 28, 2005 Accepted February 2, 2006 Bleeding in carriers of hemophilia Iris Plug, Eveline P Mauser-Bunschoten, Annette H Brocker-Vriends, Hans-Kristian Ploos van Amstel, Johanna G van der Bom, Joanna E van Diemen-Homan, Jose Willemse, and Frits R Rosendaal* Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands Netherlands Hemophilia Society, Badhoevedorp, The Netherlands Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Thrombosis and Hemostasis Research Center, Leiden University Medical Center, Leiden, The Netherlands * Corresponding author; email: F.R.Rosendaal{at}lumc.nl. A wide range of factor VIII and IX levels is observed in heterozygous carriers of hemophilia, as well as in non-carriers. We studied the effect of heterozygous hemophilia carriership on the occurrence of bleeding symptoms. A postal survey was performed among women who were tested for carriership of hemophilia in the Netherlands before 2001. The questionnaire included items on characteristics of hemophilia in the affected family members, carrier testing and bleeding problems such as bleeding after tooth extraction, bleeding after tonsillectomy and other operations. In 2004, 766 questionnaires were sent, 546 women responded (80%). Of these 274 were carriers of hemophilia A or B. The median clotting factor level of carriers was 0.60 IU/ml (range 0.05-2.20 IU/ml) compared to 1.02 IU/ml (range 0.45-3.28 IU/ ml) in non-carriers. Clotting factor levels from 0.60 to 0.05 IU/ml were increasingly associated with prolonged bleeding from small wounds, prolonged bleeding after tooth extraction, tonsillectomy and operations. Carriers of hemophilia bleed more than other women, especially after medical interventions. Our findings suggest that not only clotting factor levels at the extreme of the distribution, resembling mild hemophilia, but also mildly reduced clotting factor levels between 0.41 and 0.60 IU/ml are associated with bleeding. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Do hemophilia carriers bleed? Yes. Louis M. Aledort Blood 2006 108: 6. [Full Text] [PDF] This article has been cited by other articles: C. Chi and R. A Kadir Management of women with inherited bleeding disorders in pregnancy Obstet Gynaecol (Lond), January 1, 2007; 9(1): 27 - 33. [Abstract] [Full Text] [PDF]

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