Association Between Low Bone Mineral Density in Hemophilia Patients and Musculoskeletal Function Impairments

Rasha Ibrahim Salman ^1* , Khalid Mahdi Salih ^1*, Nidal Karim Al-Rahal ^2*

Hemophilia patients with low bone density (BMD) face higher risk with severe limitation of movement (LOM) and viral infections.

Abstract

Background: Hemophilia A (HA) and B (HB) are inherited bleeding disorders due to the partial or total deficiency of coagulation factor (F) VIII or FIX, respectively. It is associated with low bone mineral density (BMD). Method: The current study was conducted on sixty-eight Iraqi patients with hemophilia to assess BMD using a DEXA scan enrolled from the National Center of Hematology / Mustansiriyah University from July 2020 to September 2021. Various medical history characteristics were recorded as (age, type of hemophilia, severity, number and site of bleeding, smoking, and alcohol intake) as well as Functional Independence Score in Haemophilia (FISH) was used to assess musculoskeletal functions and Hepatitis C virus (HCV)/Human immunodeficiency virus (HIV) seropositivity were recorded. Results: The results found that only  39.7% of patients have positive DEXA scans characterized by low BMD (abbreviated as DX+) and 60.3 % with normal BMD (abbreviated as DX0). The average Functional Independence (FISH) score in DX+ patients is significantly lower than those in the DX0 group, and about 33.3% of patients in the DX+ group have limitation of movement (LOM), which is significantly higher than of patients in DX0 group and 70.4% of patients in DX+ group are presented with seropositive viral infection, which is significantly higher than 39% of patients in DX0 group.  Conclusion: It can be concluded that hemophilic patients with seropositive viral infection and severe LOM may be at higher risk of developing low BMD.

Keywords: Hemophilia, Bone Mineral Density, DEXA Scan, Functional Independence Score, Musculoskeletal Function

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