Document Detail


Radiosynoviorthesis in haemophilia: how safe?
MedLine Citation:
PMID:  20229681     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
One of the best procedures to prevent haemarthrosis in haemophilia has been radioactive synovectomy (radiosynoviorthesis). Since 1976 we have performed 119 radiosynoviortheses in 110 patients, aged from 3 to 40 years (mean 10), and of whom 71 were under 12 years of age. The knees were injected in 71, elbow in 29, ankles in 16, and shoulders in 3 cases. Clinical results of the procedure gave excellent results 80% of patients with no further bleeding. In the case of failure a reinjection can be given in the same joint at a 6 month interval. One of the criticisms against this method is possible chromosomal damage. In our centre, 4 studies have been made in order to see whether these changes are permanent, but all have demonstrated that chromosomal changes are reversible. Radioactive material used in 2 studies was Au-189. In 1978, 354 metaphases were studied with 61 ruptures, with 17.23% non-premalignant and 6 structural changes considered premalignant (1.69%). Further study was done in 1982, in the same group of patients with the result of 21 ruptures (3.34%) and no structural changes. The third study was performed in 13 patients that sustained radiosynoviorthesis with Re-186 in 1991. We compared the chromosomal study before and 6 months after the radioactive material injection and the results confirmed that changes appeared equally in non-irradiated and radiated patients and disappeared with time, never reaching the dangerous zone of 2%. In the group treated with Re-186 we studied an additional number of 130 metaphases with identical results and no structural changes. A study performed before and after radiosynoviorthesis with Y-90 revealed no premalignant changes. It seems than radiosynoviorthesis is safe and highly beneficial to haemophilic patients.
Authors:
Federico Fern?ndez-Palazzi; Rafael Viso; Absara Boadas; Arlette Ruiz-Saez; Aida Falcon de Vargas; Norma B de Bosch
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Srpski arhiv za celokupno lekarstvo     Volume:  138 Suppl 1     ISSN:  0370-8179     ISO Abbreviation:  Srp Arh Celok Lek     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0027440     Medline TA:  Srp Arh Celok Lek     Country:  Serbia    
Other Details:
Languages:  eng     Pagination:  39-42     Citation Subset:  IM    
Affiliation:
National Haemophilia Centre, Municipal Blood Bank, Caracas, Venezuela. feferpal@telcel.net.ve
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Chromosome Aberrations / radiation effects
Hemarthrosis / etiology,  radiotherapy*
Hemophilia A / complications*
Humans
Injections, Intra-Articular
Radioisotopes / administration & dosage*,  adverse effects
Synovial Membrane / radiation effects*
Young Adult
Chemical
Reg. No./Substance:
0/Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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