Results of Liver Biopsies, Rate of Icteric Hepatitis, and Frequency of Anti-HBs and Hbs-Antigen in Patients of the Heidelberg Hemophilia Center

Abstract

With the opening of the hemophilia center in Oct. 1972 an intensive replacement therapy with clotting factor concentrates was started the first time for many patients. Concerning the induced liver damages, three years later the following résumée could be drawn. From 113 examined patients 17(19%) acquired an icteric hepatitis(i.h.). Excluding 2 cases the interval between beginning of intensive clotting factor substitution and outbreak of i.h. was found to be 46 days in the average (13-117).1o 827 u (1 8oo-27 99o) of clotting factor concentrates had been injected until to this moment.(The average consumption by the 113 examined patients from Oct.1972 to Oct. 1975 was 57 186 u per patient and year.) In Oct.197 5 the distribution of Anti-HBs and HBs-Ag positive patients(radio immune assay) was: Frequently transfused cases (more than 15 000 u per year): Anti-HBs 86%, HBs-Ag 8%(total 94%); less frequently transfused cases”: Anti-HBs 71,5%, HBs-Ag 9,5%(total 81%). In 18 patients(not identical to those with i.h.) liver biopsies could be performed with the. following results: chronic hepatitis: 9, subsided hepatitis without activity: 4, alcoholic liver damages: 3, acute dystrophia: 1, cholanqiolitis: 1.

Synoviorthesis Versus Synovectomy in the Treatment of Recurrent Haemophilic Haemarthrosis: Long-Term Evaluation

“…However, this approach often fails to reduce the haemorrhages so that surgical or chemical synovectomy becomes the elective treatment of haemophilic recurrent haemarthrosis (1L, 20). The possible dangers of development of factor VIII antibody or chronic liver disease following to administration of large amount of blood derivatives in conservative treatment (21,22,23,24) have also to be considered. 3 (zsVo) 1 ( 8Vo) Table 6 Judgement of patients (or parents) on the two treatments Synoviorthesis SynovectomY…”

Immunitätslage bei Blutspendern und Hämophilen: Bericht über eine laufende Studie

“…Der im eigenen Krankengut festgestellte Anteil schwerer Hämophiler mit Markern für Hepatitis B-Virus von 85% und die bei erhöhten Transaminasen bei etwa der Hälfte dieser Hämophilen decken sich mit den Ergebnissen anderer Untersucher (12,23,26,27). Bei den Patienten mit leichter Hamophilie fanden sich nur bei einem von 5 Patienten Marker für'eine.…”

On the Way to Virus-Safe Blood Coagulation Factor Concentrates

“…8 Although only 15% of the 114 patients developed jaundice, the infection rate was nearly 100%, showing serological markers of hepatitis B (Table 4). 8,10 What did this mean? Looking for an explanation, I came across an article published by Creutzfeldt et al, 9 who in 1966 had done a prospective study and observed posttransfusion hepatitis in nonhemophilic patients who had received blood transfusions.…”

“…8,[10][11][12][13] In the medical literature, there were only a few reports published on liver biopsies in patients with hemophilia. 14 If liver biopsies had been tried at all, also later, 15-18 they were performed only in patients with elevated transaminase levels.…”

“…Until the early 1980s, 51 biopsies had been performed on 43 patients. 13,19 Tables 7 8,10-12 and 8 8,[10][11][12][15][16][17][18][19]32 show the distribution of liver damage. In the 1970s, however, when the number of our biopsy findings was smaller, 8,10 the distribution was similar.…”