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Peter H. Levine, MD; Bernard A. McVerry, MD; Allyn E. Segelman, DMD; Catherine M. Cranford; Seymour Zimbler, MD

Arch Intern Med. 1976;136(7):792-794.

Abstract
One hundred hemophiliacs were examined at a formal comprehensive health care clinic. Sixty-eight percent had abnormal results of liver function tests, and 26% had spleens that were palpable. Measurement of range of motion of knees, ankles, hips, shoulders, and elbows showed a high incidence of hemophilic arthropathy and established a precise baseline by which to judge efficacy of therapy. Results of dental examination disclosed a 14% incidence of multiple severe caries, which is an incidence lower than that of the population as a whole. Examples of inadequate dosage of replacement therapy (16%) and chronic delay in application of self-therapy (14%) were discovered. An 8% incidence of hypertension was noted; prior experience suggests that the combination of hypertension and hemophilia may be lethal. Other clinical and laboratory data also illustrate the importance of a periodic, formally structured, comprehensive examination of hemophiliacs.

(Arch Intern Med 136:792-794, 1976)

Author Affiliations
From the Blood Coagulation Laboratory, Hematology Service, and the Orthopedic Surgical Service, New England Medical Center Hospital; the departments of medicine and surgery, Tufts University School of Medicine; and the Department of Oral Surgery, Tufts University School of Dental Medicine, Boston (Dr Segelman).

Footnotes
Received for publication Sept 28, 1975; accepted Dec 26.

Reprint requests to Blood Coagulation Laboratory, Memorial Hospital, 119 Belmont St, Worcester, MA 01605 (Dr Levine).

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