Definition
Rare bleeding
disorders (RBDs) are very rare diseases, relatively neglected
until recently by health care providers, advocacy organizations
and pharmaceutical companies. Haemophilia A and B are the most
frequent inherited bleeding disorders. Together with von Willebrand
disease, a defect of primary hemostasis associated with a secondary
defect in coagulation factor VIII (FVIII), these X-linked disorders
include 95% to 97% of all the inherited deficiencies of coagulation
factors -1-.
The other
3-5% are represented by the less common inherited disorders. This
include deficiency of fibrinogen, prothrombin, factors V, combined
V+VIII, VII, X, XI and XIII. These disorders are inherited in
an autosomal recessive manner (Figure
1) and their prevalence is approximately 1:500.000 or
less in the general population of western countries (Table
1) -1-
However their frequency is increased 10-20 times where consanguineous
marriages are practised such as Middle East countries and in Southern
India - 2-.
The natural history and spectrum of clinical manifestations of
RBDs are not well established, since few centres in the world
have the opportunity to see a significant number of these rare
patients.