Introduction
Hemophilia is an X-linked recessive hemorrhagic disease due to mutations
in the F8 gene (hemophilia A or classic hemophilia)
or F9 gene (hemophilia B), leading to deficiency of factor VIII
and IX respectively. The large size of the F8 gene makes it more
susceptible to mutation events than the smaller F9 gene.
Thus, Hemophilia A is more common than hemophilia B. Hemophilia affects
more than 1.2 million individuals worldwide and occurs in all racial and
ethnic groups. The majority of hemophilia patients give a positive
family history with an x-linked inheritance pattern. However, a negative
family history does not rule out hemophilia, because 20% to 30% of
cases arise from a recent mutation, particularly in those with severe
disease.1,2
The symptoms and signs of hemophilia A and B are indistinguishable. The
severity and onset of bleeding depend on the severity of the disease.
The Severity of the disease classified based on the factor activity as
severe (<1%), moderate (between 1 and 5%), and mild (between 6
to 40%). Spontaneous bleeding is common in severe disease during early
life and in moderate disease, bleeding usually occurs after minor
traumas and surgical procedures. 3,4
The presence of hemophilia A and B in one patient is extremely rare, and
only a few case reports have been published. The clinical presentation
of patients with coexisting hemophilia A and B was similar to the
isolated hemophilia. Here, we present a 16-years-old male Ethiopian
patient who initially presented with prolonged bleeding of 10 days
duration after a circumcision procedure. To the best of our knowledge,
this is the only case report from Africa.
Keywords : hemophilia A, hemophilia B