PB1257 - Participation of non-severe hemophiliac A patients without prophylaxis in agricultural physical activities. Experience of a center in a rural area.

Background: Non-severe hemophiliac A patients usually develop physical activity that is often similar to that of the general population, and in rural areas agricultural work with high joint impact is common. However, there is no case history as to whether this type of particularly intense work is indicated or, at least, described in the scientific literature.

Aims: Document the incidence of agricultural work (occasional or continuous) and its joint impact in non-severe hemophilic A patients without prophylactic treatment residing in a rural area.

Methods: A total of 10 non-severe adult hemophiliac A patients without prophylactic treatment, residing in rural areas and indicating their participation in agricultural work (permanent or occasional), to which their joint health was evaluated by ultrasound using the HEAD-US scale.

Results: The median age was 22 years (range: 18-32 years) and with FVIIIc levels of 25% (range: 20-40%) without exposure to prophylactic treatment. The selected patients mostly indicated occasional agricultural work (olive harvesting or grape harvest), often on family plots. Only 1 patient indicated that he did it routinely, the same one who had baseline FVIIIc levels of 35%. After assessment of joint health by ultrasound using the HEAD-US scale, it was found that 10% of the analyzed population had a score ≥1 point (minimal synovitis in the left ankle). None have reported occupational accidents during agricultural work, nor the need for complementary healthcare during the harvest season.

Conclusion(s): More studies are needed to more extensively visualize the impact of agricultural physical activity (occasional or continuous) in non-severe hemophilic patients without prophylaxis, emphasizing the great usefulness of routine joint assessment by ultrasound in this type of patient to early detection of arthropathy.