Osteoporosis common in adults with hemophilia

Reuters Health
Wednesday, February 14, 2007
By C. Vidyashankar, MD
DELHI (Reuters Health) - In India, patients with hemophilia are at increased risk of developing osteoporosis, according to the results of a study.
Hemophilia is a potentially deadly disorder caused by a deficiency of a particular blood protein called Factor VIII, which is essential to the blood clotting process. Hemophiliacs may suffer recurrent bleeding, mostly into joints and muscles.
Dr. Anish P. Nair and colleagues from the King Edward Memorial Hospital, Mumbai (Bombay), India, evaluated the bone health of 50 adults with hemophilia who were between 20 and 50 years of age, and an equal number of healthy controls.
Osteoporosis was present in the lumbar spine in half of the hemophiliacs and in the hip joint in around a third, they report.
The average bone mineral density in the lumbar spine and left hip was significantly lower among hemophiliacs than among healthy controls, they also report. Six of the hemophiliacs had a history of fractures, as compared to none of the controls.
Inadequate treatment of hemophilia due to the high cost of Factor VIII replacement leads to permanent joint damage in a great majority of hemophiliacs in India, co-author Dr. Kanjaksha Ghosh told Reuters Health.
Consequent lack of physical activity because of joint pain, or fear of injury, as well as co-existing hepatitis C infection, and vitamin D deficiency could all contribute to the risk of developing osteoporosis, he added.
While routine screening for osteoporosis is not recommended in hemophiliacs, regular exercise along with optimal treatment for the blood disorder, physical therapy and treatment of vitamin D deficiency would certainly help prevent osteoporosis, Ghosh concluded.
SOURCE: American Journal of Hematology February 2007.