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In mild cases, treatment may involve the use of drugs that stimulate the release of deficient clotting factors. In severe cases, bleeding may only stop if the clotting factor that is missing is replaced through infusion of donated human blood in the form of fresh frozen plasma or cryoprecipitate.
- Hemophilia A in mild episodes may require infusion of a drug called desmopressin or DDAVP. Severe bleeding episodes will require transfusions of human blood clotting factors. Hemophiliacs are encouraged to receive physical therapy to help damaged joints and to exercise in non-contact sports such as swimming, bicycle riding, or walking.
- Christmas disease patients are treated similarly to hemophilia A patients. There are commercial products and human blood products available to provide coagulation. Cryoprecipitate was invented in 1965 to replace the need for whole plasma transfusions, which introduced more volume than needed. By the 1970s, people were able to infuse themselves with freeze-dried clotting factor. Superficial wounds can be cleaned and bandaged. Parents of hemophiliac children receiving immunizations should inform the vaccination provider in advance to decrease the possibility of bleeding problems. These children should probably not receive injections which go into the muscle.
- Treatment for disseminated intravascular coagulation patients is complicated by the large variety of underlying causes of the disorder. If at all possible, the physician will first treat this underlying disorder. If the patient is not already bleeding, this supportive treatment may eliminate the DIC. However, if bleeding is occurring, the patient may need blood, platelets, fresh frozen plasma, or other blood products. Heparin has been controversial in treating DIC, but it is often used as a last resort to stop hemorrhage. Heparin has not proven useful in treating patients with DIC resulting from heat stroke, exotic snakebites, trauma, mismatched transfusions, and acute problems resulting from obstetrical complications.
- Secondary acquired thrombocytopenia is best alleviated by treating the underlying cause or disorder. The specific treatment may depend on the underlying cause. Sometimes, cortocoosterids or immune globulin may be given to improve platelet production.
- Von Willebrand's disease is treated by several methods to reduce bleeding time and to replace factor VIII, which consequently will replace the Von Willebrand factor. This may include infusion of cryoprecipitate or fresh frozen plasma. Desmopressin may also help raise levels of the Von Willebrand factor.
- Hypoprothrombinemia may be treated with concentrates of prothrombin. Vitamin K may also be produced, and in bleeding episodes, the patient may receive fresh plasma products.
- Factor XI (hemophilia C) is most often treated with plasma, since there are no commercially available concentrates of factor XI in the United States. Factor VII patients may be treated with prothrombin complex concentrates. As of early 1998, factor VII concentrate was not licensed in the United States and could only be used with special permission.
Source: The Gale Group. Gale Encyclopedia of Medicine, 3rd ed.";