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Hematologist, oncohematologist

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The causes of increase and decrease in factor VIII (antigemofilnogo globulin A)

Alexey Portnov, medical expert
Last reviewed: 20.11.2021

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About a third of the "carriers" of hemophilia A, the activity of factor VIII is 25 to 49%. In patients with mild form and "carriers" of hemophilia A, clinical manifestations of the disease occur only after injuries and surgical interventions.

The minimal hemostatic level of factor VIII activity in the blood for performing operations is 25%, with a lower content the risk of postoperative hemorrhage is extremely high. The minimum hemostatic level of factor VIII activity in the blood for stopping bleeding is 15-20%, with a lower content the stop of bleeding without the introduction of a factor VIII patient is impossible. With von Willebrand's disease, the minimum hemostatic level of factor VIII activity for stopping bleeding and for the operation is 25%.

With ICE-syndrome, beginning with the II stage, there is a distinct decrease in the activity of factor VIII due to consumption coagulopathy. Severe liver disease can lead to a decrease in the content of factor VIII in the blood. The content of factor VIII decreases with von Willebrand's disease, as well as in the presence of specific antibodies to factor VIII.

The activity of factor VIII is significantly increased after splenectomy.

In clinical practice it is very important to differentiate hemophilia and von Willebrand's disease.

Indicators of coagulogram in hemophilia and von Willebrand disease

Index	Hemophilia	Von Willebrand's Disease
Blood clotting time	Increased	Norm
Duration of bleeding	Norm	Increased
Aggregation of platelets with ristocetin	Norm	Decreased
Prothrombin time	Norm	Norm
APTTV	Increased	Norm
Thrombin time	Norm	Norm
Fibrinogen	Norm	Norm

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