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"The Unfamiliar Bleed" Letter to the Editor

Reader points out different hemophilia severity levels in family

Read "The Unfamiliar Bleed" article.

Dear Editor,

I enjoy reading HemAware and, in the past, have made copies of the articles to give to my patients. I rely on the information in the articles to be true and up to date. This is why I was very dismayed to find a serious mistake in the article “The Unfamiliar Bleed” (Spring 2011, p. 32).

In the beginning of the piece, the author establishes that the central character, Andrew Morado, has severe hemophilia and suffered many bleeds in his ankles. In the second paragraph, the author goes on to state that Andrew has two brothers, one with mild hemophilia and one unaffected.

Anyone with experience in hemophilia would know that the degree of severity of hemophilia is inherited. There cannot be one child with severe hemophilia and another with mild. If one is severe, the other has to be severe. This in itself may not seem such a big deal, but the topic of inherent severity is frequently discussed with new families in clinic. We want them to have the correct information.

I appreciate your attention and time, and hope you are able to give a correction in your next edition.

Laurel J. Pennick, LCSW
Arizona Hemophilia and Thrombosis Treatment Center


Editor’s reply:

Thank you for your letter and pointing out the rarity of this case. We spoke with Andrew’s mom, Alicia Morado, who explained that her two sons with hemophilia do have different severity levels. Alicia recognizes the near-impossibility of this and says her sons have been tested twice. Andrew has less than 1% clotting ability, placing him in the severe category, while Tony has 7% to 14%, placing him in the mild category. Each boy displays the characteristics of his respective level: Andrew gets many bleeds and needs prophylaxis treatment; Tony bleeds infrequently.

The Morados’ hemophilia treatment center (HTC) staff has mentioned to the family how unusual this is. The boys’ hematologist also verified this with HemAware by e-mail. As you pointed out, the degree of severity of hemophilia is inherited and is the same in the vast majority of families. We should have made it clear in the article that the Morados’ difference in severity levels was not the norm.

Thank you for calling this to our attention,

Melanie Padgett Powers
HemAware managing editor