C-Y Chang1,2,3, T-Y Li4,5, S-N Cheng6,7, R-Y Pan5,8, H-J Wang3,9, S-Y Lin1,3,10, Y-C Chen5,11. 1. Graduate Institute of Clinical Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan. 2. Division of Pediatric Hematology/Oncology, Taipei Medical University Hospital, Taipei, Taiwan. 3. Hemophilia Center, Taipei Medical University Hospital, Taipei, Taiwan. 4. Department of Rehabilitation, Tri-Service General Hospital, Taipei, Taiwan. 5. Hemophilia Care and Research Center, Tri-Service General Hospital, Taipei, Taiwan. 6. Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, Taipei, Taiwan. 7. Department of Pediatrics, National Defense Medical Center, Taipei, Taiwan. 8. Department of Orthopedics, Tri-Service General Hospital, Taipei, Taiwan. 9. Department of Medical Imaging, Taipei Medical University Hospital, Taipei, Taiwan. 10. Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. 11. Division of Hematology/Oncology, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
Abstract
INTRODUCTION & AIMS: Haemophilic arthropathy (HA) is a major complication in patients with haemophilia (PWH), but the study of age-specific prevalence and severity of HA is very limited in Asian countries. MATERIALS & METHODS: This study retrospectively reviewed 146 severe- and moderate-type Taiwanese PWH aged 4-73 years, with roentgenograms of elbows, knees and ankles and calculated Pettersson scores. RESULTS: The prevalence of HA, mean number of HAs per patient and mean Pettersson scores of all the joints were 42.8%, 1.3 and 1.9 points in PWH aged 4-10 years; 64.3%, 1.4 and 4.1 points in PWH aged 11-19 years; 97.1%, 2.9 and 15.6 points in PWH aged 20-29 years; 93.1%, 4.4 and 33.1 points in PWH aged 30-39 years; 100%, 5.1 and 46.1 points in PWH aged 40-49 years and 100%, 5 and 49.6 points in PWH aged ≥50 years, respectively. There was a high prevalence of HA for PWH aged ≥20 years. Among PWH aged <20 years, prevalence of HA was low and mild ankle arthropathy was the most common. Besides, in the four age groups aged <40 years, the prevalence of ankle arthropathy was the highest, followed by elbow arthropathy and then knee arthropathy. CONCLUSIONS: Although severe arthropathy of the six major joints was rare in PWH aged <30 years, it increased rapidly in PWH after 30 years. Analysis of clinical correlates suggested that age, severity of haemophilia, absence of prophylaxis and presence of HCV infection correlated positively with Pettersson scores.
INTRODUCTION & AIMS: Haemophilic arthropathy (HA) is a major complication in patients with haemophilia (PWH), but the study of age-specific prevalence and severity of HA is very limited in Asian countries. MATERIALS & METHODS: This study retrospectively reviewed 146 severe- and moderate-type Taiwanese PWH aged 4-73 years, with roentgenograms of elbows, knees and ankles and calculated Pettersson scores. RESULTS: The prevalence of HA, mean number of HAs per patient and mean Pettersson scores of all the joints were 42.8%, 1.3 and 1.9 points in PWH aged 4-10 years; 64.3%, 1.4 and 4.1 points in PWH aged 11-19 years; 97.1%, 2.9 and 15.6 points in PWH aged 20-29 years; 93.1%, 4.4 and 33.1 points in PWH aged 30-39 years; 100%, 5.1 and 46.1 points in PWH aged 40-49 years and 100%, 5 and 49.6 points in PWH aged ≥50 years, respectively. There was a high prevalence of HA for PWH aged ≥20 years. Among PWH aged <20 years, prevalence of HA was low and mild ankle arthropathy was the most common. Besides, in the four age groups aged <40 years, the prevalence of ankle arthropathy was the highest, followed by elbow arthropathy and then knee arthropathy. CONCLUSIONS: Although severe arthropathy of the six major joints was rare in PWH aged <30 years, it increased rapidly in PWH after 30 years. Analysis of clinical correlates suggested that age, severity of haemophilia, absence of prophylaxis and presence of HCV infection correlated positively with Pettersson scores.
Authors: Raúl PÉRez-Llanes; Elena Donoso-ÚBeda; Javier MeroÑO-Gallut; Jose Antonio Lopez-Pina; Rubén Cuesta-Barriuso Journal: J Rehabil Med Clin Commun Date: 2020-06-09