Spontaneous penoscrotal bleeding in haemophilia A

Description

A boy aged 3 years presented to the emergency department with sudden onset of painless penoscrotal swelling and ecchymosis of 2 days. There was no history of trauma or similar presentation before this episode. No family history of bleeding disorder was present. On examination, his vitals were stable. Temperature of the scrotum and penis was normal. There was penoscrotal oedema and ecchymosis with loss of scrotal rugosities and normal shape of penis (figure 1). His blood investigations were unremarkable except for prolonged aPTT. Factor assay was performed which came out to be moderate factor VIII deficiency (3.4 IU/dL). The patient was started on intravenous recombinant factor VIII as per World Federation of Haemophilia (WFH) protocol.1 Bleeding was confirmed on high-resolution ultrasonography scan of the scrotum. The patient had an uneventful recovery in a week.

Learning points

Deficiencies of factor VIII and IX...

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