High-titre factor VIII inhibitor in two children with mild haemophilia A

A frequently encountered complication of therapy given to patients with sev ere haemophilia A is the development of antibodies to infused factor VIII. While much less common, inhibitors also occur in patients with mild or mode rate severity haemophilia A. Often thought to be of low titre and transient , several cases of high-titre inhibitors have been described in patients wi th mild or moderate haemophilia A. Generally these occur in adults or adole scents following significant infused factor VIII exposure. A review of repo rted cases revealed only two cases of high-titre inhibitor formation in mil d haemophilia A patients younger than 10 years of age. We wish to report ou r experience with an additional two children with mild haemophilia A and hi gh titre inhibitors, and offer suggestions for the management of these chil dren.