The symptoms of haemophilia are directly linked to how much clotting factors you have in your blood compared to the normal amount. For example:
- between 5-30% of the normal amount would cause mild haemophilia,
- between 1-5% of the normal amount would cause moderate haemophilia, and
- less than 1% of the normal amount would cause severe haemophilia.
Children who are born with mild haemophilia may not experience any symptoms of the condition for many years. The condition usually only becomes apparent if the child has a dental procedure, such as a filling, an accident that significantly breaks the skin, or surgery. Each of these three events could result in unusually prolonged bleeding.
Where circumcision (the removal of the foreskin) is common, such as in Islamic and Jewish communities, cases of mild haemophilia may become apparent if a boy experiences prolonged bleeding after being circumcised.
Children who are born with moderate haemophilia will have skin that bruises very easily. They may also experience symptoms of internal bleeding around the joints, particularly if they have taken a knock, or a fall, that affects their joints. Internal bleeding around the joint is known as a 'joint bleed'.
The symptoms of a joint bleed usually begin with a tingly feeling of irritation and mild pain in the affected joint.
Left untreated, further symptoms can develop such as:
- more severe joint pain,
- stiffness, and
- the site of the bleed can become hot, swollen, and tender.
The most common joints that are affected by joint bleeding are:
- the ankle joints,
- the knee joints, and
- the elbow joints.
Less commonly, the shoulder and hip joints are also be affected.
As with mild haemophilia, children with moderate haemophilia will also experience prolonged bleeding after dental and surgical procedures and accidents that break the skin.
The symptoms of severe haemophilia are similar to moderate haemophilia, but episodes of joint bleeding are more frequent and severe.
Children with severe haemophilia can also experience symptoms of spontaneous bleeding, which means that they begin bleeding for no apparent reason.
Most cases of spontaneous bleeding take the form of nosebleeds and bleeding gums.
When to seek emergency medical help
In cases of haemophilia, there is a small risk that bleeding inside the skull will occur. This is known as an intracranial haemorrhage. It is estimated that 3% of people with moderate or severe haemophilia will experience an intracranial haemorrhage at some point their life.
Bleeding inside the skull can be very serious and should be treated as a medical emergency.
However, spontaneous bleeding inside the skull is very uncommon, and usually only occurs as a result of a head injury. Symptoms include:
- severe headache,
- stiff neck,
- change in mental state, such as confusion,
- speaking difficulties, such as slurred speech,
- changes in vision, such as double vision,
- loss of coordination,
- loss of balance, and
- paralysis of some, or all, of the facial muscles.
Dial 999 to request an ambulance if you suspect that you, or your child, has bleeding inside the skull.
Joint: Joints are the connection point between two bones that allow movement.
Nausea: Nausea is when you feel like you are going to be sick.
Brain: The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.
Pain: Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Spine: The spine supports the skeleton, and surrounds and protects the delicate spinal cord and nerves. It is made up of 33 bones called the vertebrae.
Blood: Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Vomiting: Vomiting is when you bring up the contents of your stomach through your mouth.
Tissue: Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.
Swelling: Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Faeces: Stool (also known as faeces) is the solid waste matter that is passed from the body as a bowel movement.
Deficiency: If you have a deficiency it means you are lacking in a particular substance needed by the body.