PB1137 - Intracranial Haemorrhage in Children with Haemophilia in Turkey

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

MS

Melike Sezgin Evim

Assoc. Prof. Dr.
Bursa Uludag University Pediatric Hematology
Bursa, Bursa, Turkey
Canan Albayrak, MD

Professor
Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
Samsun, Samsun, Turkey
EZ

Emine Zengin

Assoc.Prof.
Pediatric Hematologist
Kocaeli, Kocaeli, Turkey
EY

Ebru Yılmaz

Dr.
Pediatric Hematologist
Kayseri, Kayseri, Turkey
N�

Nihal Özdemir

DR
Pediatric Hematologist
izmir, Izmir, Turkey
ME

Mehtap Ertekin

Dr
Pediatric Hematologist
İzmir, Izmir, Turkey
G�

Gülnihal Özdemir

Prof.
Pediatric Hematologist
İstanbul, Istanbul, Turkey
AB

Ayşenur Bahadır

Dr
Pediatric Hematologist
Trabzon, Trabzon, Turkey
BY

Barış Yılmaz

dr
Pediatric Hematologist
İstanbul, Istanbul, Turkey
SA

Sinan Akbayram

Prof.
Pediatric Hematologist
Gaziantep, Gaziantep, Turkey
FK

Funda Küpesiz

Dr
Pediatric Hematologist
Antalya, Antalya, Turkey
HT

Hüseyin Tokgöz

Dr
Pediatric Hematologist
Konya, Konya, Turkey
BT

Burçak Tatlı Güneş

Dr
Pediatric Hematologist
İzmir, Izmir, Turkey
YA

Yusuf Ziya Aral

Prof.
Pediatric Hematologist
Aydın, Aydin, Turkey
CA

Can Acıpayam

Prof.
Pediatric Hematologist
Kahramanmaraş, Kahramanmaras, Turkey
FB

Fatma Burcu Belen Apak

Assoc.Prof.
Baskent University Medical Faculty Department of Pediatric Hematology and Oncology
Ankara, Ankara, Turkey
Aysegul Unuvar, MD

Prof. Dr.
Istanbul University, Istanbul School of Medicine, Division of Pediatric Hematolgy&Oncology
Istanbul, Istanbul, Turkey

Presenting Author(s)

Serap Karaman, MD

Prof Dr
Istanbul University, Istanbul School of Medicine, Division of Pediatric Hematology&Oncology
Istanbul, Istanbul, Turkey

Co-Author(s)

Hale Oren, MD

Department of Pediatric Hematology
Dokuz Eylül University Faculty of Medicine
Izmir, Izmir, Turkey

Background: Intracranial haemorrhage (ICH) is a rare but life-threatening complication.

Aims: To evaluate risk factors for ICH, mortality rate, long-term morbidity and affecting factor of sequelae in patients with haemophilia.

Methods: We contacted pediatric hematologist by e-mail and information about children who had intracranial bleeding was requested.

Results: In total 86 patients, haemophilia A/B ratio was 65/21. The numbers of severe, moderate and mild haemophilia were 65, 15, and 6, respectively. Nine patients had no complaints. Seizure was the most common complaint and was present in 34 patients, followed by lost of consciousness (n: 21) and nausea/vomiting (n: 10). Other complaints were focal neurological findings (n: 4), headache (n: 3), arrest (n: 2), irritability (2) and hypotonia (1).
Thirteen (15%) patients who bleed in the neonatal period, Thirty-three of the remaining 73 patients were not known to have hemophilia. Haemophilia diagnosis of 40 patients was known before ICH, only 8 of them were under prophylaxis.
The most common bleeding locations were parenchymal (29/86), combined (21/86) and subdural (18/86) haemorrhages. Other bleeding sites were epidural (9/86), subarachnoid (5/86) and ventricular (4/86).
After the neonatal peiod, parenchymal bleeding was common in the diagnosed group (17 vs 7) and combined bleeding was common in the undiagnosed group (14 vs 4). The undiagnosed group was operated on more frequently in the first 24 hours (18 vs 6).
Five patients died during the first ICH. The rate of loss in the neonatal period was higher compared to other periods (15% (2/13) vs 4%(3/73)).
The rate of neurological sequelae was 25/81 (30%). In the multiple regression analysis, only shift was found to be significant (OR: 4.464, CI 95% 1.151- + 17.309. (p 0.031)).

Conclusion(s): ICH are an important cause of mortality and morbidity, sequelae can be reduced by increasing compliance to prophylaxis.