Common Symptoms of Hemophilia

Hemophilia affects the blood’s ability to clot, which leads to a range of bleeding-related symptoms. These symptoms may vary depending on the severity of the condition and whether the person has mild, moderate, or severe hemophilia. Below are the most common signs to watch for:

1. Frequent Nosebleeds
   People with hemophilia often experience spontaneous nosebleeds—bleeding from the nose without any apparent cause, such as injury or dry air. These nosebleeds can be difficult to stop and may last longer than usual, even with applied pressure. Recurrent nosebleeds can lead to anemia (low red blood cell count) if not managed properly.

2. Easy Bruising
   A hallmark symptom of hemophilia is bruising that occurs easily or without any known injury. The bruises may be larger and darker than typical bruises and often appear in unusual locations. This happens because even minor bumps or pressure can cause bleeding under the skin when clotting factors are missing.

3. Prolonged Bleeding
   Whether it’s a small cut, a scraped knee, or a dental procedure, people with hemophilia may bleed much longer than normal. This is because their blood lacks the proteins needed to form stable clots. Without proper treatment, even minor bleeding can become dangerous, particularly after surgery or trauma.

4. Joint Problems (Hemarthrosis)
   One of the most serious complications of hemophilia is internal bleeding in joints, especially in the knees, ankles, and elbows. Symptoms of joint bleeding include:

   • Pain or tenderness in the joint

   • Swelling and warmth

   • Stiffness or reduced range of motion

If left untreated, repeated joint bleeds can lead to chronic pain, joint deformity, and a condition called hemophilic arthropathy, where the joint becomes permanently damaged.

5. Blood in Urine or Stool
   The presence of blood in the urine (hematuria) or stool (melena or hematochezia) may indicate internal bleeding in the urinary or gastrointestinal tract. This symptom is particularly serious and requires immediate medical attention, as it can signal bleeding from organs like the bladder, kidneys, intestines, or stomach.

Hemophilia in India: A Growing Concern

Although hemophilia is classified as a rare disorder globally, it is becoming an increasing health challenge in India. Despite advances in medical science, thousands of patients go undiagnosed, untreated, or misdiagnosed, primarily due to a lack of awareness and limited access to specialized healthcare.

According to the World Federation of Hemophilia (WFH):

• India ranks second in the world in terms of the number of hemophilia cases.

• However, a large number of patients remain invisible to the healthcare system because they have never been formally diagnosed.

Why Hemophilia Often Goes Undetected in India

There are several reasons why hemophilia continues to be under-recognized and under-treated:

1. Lack of Awareness

   • Many people are unfamiliar with hemophilia, its symptoms, or the fact that it can affect children from birth.

   • Even some healthcare professionals, especially in general practice, may miss the early signs or confuse them with other conditions.

2. Limited Access to Testing

   • Rural and semi-urban areas often lack the proper diagnostic tools such as clotting factor assays and genetic testing.

   • This results in delayed or missed diagnoses, which can lead to complications such as joint damage or chronic pain.

3. Social Stigma and Cultural Barriers

   • Families may hide the condition due to fear of judgment, shame, or marriage concerns.

   • In some regions, myths and misconceptions discourage families from seeking timely medical help.

4. Shortage of Clotting Factor Concentrates

   • Public hospitals often struggle with limited supply of life-saving clotting factors, which are essential for managing bleeding episodes.

   • This shortage is a critical barrier, especially for low-income patients who cannot afford private care or imported medicines.