Vascular endothelial growth factor A as an early diagnostic marker of hemophilic arthropathy in children with severe hemophilia A

Background
Vascular endothelial growth factor A (VEGF-A) is a key angiogenic factor with properties that inhibit apoptosis and stimulate cell division in endothelial cells, while also increasing vascular permeability and facilitating cell migration.


Aim
To assess VEGF-A levels in children with severe hemophilia A (HA) and its effects on the development of hemophilic arthropathy.


Patients and methods
This research used a case–control study approach, involving 40 male children who were between 1 and 18 years of age and suffered from severe HA (group I), and a control group comprising 40 healthy male children (group II). Serum VEGF-A levels were measured in all patients.


Results
VEGF-A activated partial thromboplastin time, and clotting time were significantly greater in group I than in group II (P<0.05). The number of afflicted joints, the hemophilic joint health score, the frequency and length of bleeding episodes, and the clotting time and activated partial thromboplastin time test findings were all significantly positively correlated with VEGF-A levels at a significance level of P less than 0.05. A substantial negative connection (P<0.05) was found between factor VIII and hemoglobin. The best cut off level for VEGF-A in discriminating patients from control groups was 116.68 yielding sensitivity of 82.50% and specificity of 85.0% (P<0.001).


Conclusions
VEGF-A could be used as a potential early diagnostic biomarker of hemophilic arthropathy in children with severe HA.