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What is the Difference Between Hemophilia A and B and C

The key difference between hemophilia A and B and C is that hemophilia A is due to the deficiency of clotting factor VIII, while hemophilia B is due to the deficiency of clotting factor IX and hemophilia C is due to the deficiency of clotting factor XI.

Hemophilia A and B are due to an inherited X-linked recessive trait with a defective gene located on the X chromosome. Males have one X chromosome, and females have two X chromosomes. In males, the individual diagnosed with hemophilia contain a defective gene on the X chromosome. Therefore, most patients with hemophilia are males. Hemophilia C does not follow any X-linked pattern since the mutation occurs in a gene located on chromosome 4. Therefore, hemophilia C affects both genders equally.

CONTENTS

1. Overview and Key Difference
2. What is Hemophilia A
3. What is Hemophilia B
4. What is Hemophilia C
5. Similarities – Hemophilia A and B and C
6. Hemophilia A vs B vs C in Tabular Form
7. Summary – Hemophilia A vs B vs C

What is Hemophilia A?

Hemophilia A is a hereditary bleeding disorder caused by the lack of a blood clotting factor VIII. Factor VIII is important for the blood clotting procedure. When a small cut or a bleeding injury takes place, a series of reactions occurs to help the blood clot. This process is known as the coagulation cascade. It involves special proteins called coagulation factors. Factor VIII is one such coagulation factor. Important sites that hemophilia A affects are joints, muscles, brain, and digestive tract. Muscle and joint hemorrhages and cerebral and digestive tract hemorrhages are indications of hemophilia A. Other symptoms of hemophilia A are inadequate blood clotting of a serious or mild injury; in a severe case, it may lead to spontaneous hemorrhage.

Figure 01: X- linked Recessive Trait

Diagnosis for hemophilia A is made using coagulation factor assays. Most treatments for hemophilia include replacing the missing or deficient protein factor VIII. Therefore, the main medication is concentrated factor VIII called the clotting factor. There are two types of this factor: plasma-derived and recombinant. And, these factor therapies are injected into a vein.

What is Hemophilia B?

Hemophilia B is a hereditary bleeding disorder caused due to the lack of blood clotting factor IX. Lack of factor IX is rare than other factors, and therefore, hemophilia B is a rare disorder. Symptoms of hemophilia B include easy bruising, urinary tract bleeding called hematuria, nose bleeding called epistaxis, and bleeding in joints known as hemarthrosis. Patients affected with hemophilia B show higher periodontal diseases with a lack of oral hygiene and health care.

Figure 02: Hemophilia Diagnosis

The most prominent symptom of hemophilia B is gingival bleeding during the eruption of primary teeth or tooth extraction. Severe hemophilia B causes spontaneous bleeding of oral tissues, lips, and gingiva. Factor IX deficiency leads to a spontaneous hemorrhage or a mild trauma if not treated immediately. Diagnosis for hemophilia B is carried out by coagulation screening test, coagulation factor assays, and bleeding scores. Treatment for hemophilia B includes the intravenous infusion of factor IX and blood transfusions.

What is Hemophilia C?

Hemophilia C, which is also known as plasma thromboplastin antecedent deficiency, is a mild form of hemophilia due to the deficiency of blood clotting factor XI. Hemophilia C is an autosomal recessive inheritance since the gene is located on chromosome 4. Hemophilia C is occasionally visible in individuals with systemic lupus erythematosus. Individuals affected with hemophilia C do not bleed spontaneously. Therefore, complications such as hemorrhages are most likely to occur after a surgery or serious injury. However, symptoms of hemophilia C include oral bleeding, nose bleeding, blood with urine, post-partum bleeding, and bleeding of tonsils.

Diagnosis of hemophilia C is dependent on prolonged activated partial thromboplastin time study. It is a blood test that characterizes the coagulation of blood with time. Treatment for hemophilia C is medication tranexamic acid during or after an incident of bleeding. Fresh frozen plasma or recombinant factor XI is injected in serious incidents.

What are the Similarities Between Hemophilia A and B and C?

What is the Difference Between Hemophilia A and B and C?

Hemophilia A, B, and C are hereditary bleeding disorders due to the lack of blood clotting factors VIII, IX, and XI, respectively. Thus, this is the key difference between hemophilia A and B and C. Besides, hemophilia A and B are mostly seen in males, while hemophilia C affects both genders equally. Moreover, hemophilia A and B are X-linked recessive, while hemophilia C is autosomal recessive.

The below infographic presents the differences between hemophilia A and B and C in tabular form for side by side comparison.

Summary – Hemophilia A vs B vs C

Hemophilia A is a hereditary bleeding disorder caused by the lack of blood clotting factor VIII. Hemophilia B is a hereditary bleeding disorder caused by the lack of blood clotting factor IX. Hemophilia C, which is also known as plasma thromboplastin antecedent deficiency, is a mild form of hemophilia due to the deficiency of blood clotting factor XI. Hemophilia A and B are due to inherited X-linked recessive traits with a defective gene located on the X chromosome. In contrast, hemophilia C is associated with a defect in the gene on the chromosome. So, this summarizes the difference between hemophilia A and B and C.

Reference:

1. “Hemophilia A.” MedlinePlus, U.S. National Library of Medicine.
2. “Hemophilia B.” MedlinePlus, U.S. National Library of Medicine.

Image Courtesy:

1. “X-linked recessive (2)” By File:Autosomal recessive – en.svg: Domaina, Kashmiri and SUM1Derivative work: SUM1 – Based off of File:Autosomal recessive – en.svg (CC BY-SA 4.0) via Commons Wikimedia
2. “Hemophilia Diagnosis Fig 3” By Moutasem z – Own work (CC BY-SA 3.0) via Commons Wikimedia