World Health Organization Collaborating Center for Inherited Bleeding Disorders
"ANGELO BIANCHI BONOMI" HEMOPHILIA AND THROMBOSIS CENTER IRCCS MAGGIORE HOSPITAL, MANGIAGALLI AND REGINA ELENA FOUNDATION"LUIGI VILLA" FOUNDATION DEPARTMENT OF MEDICINE AND MEDICAL SPECIALITIES, UNIVERSITY OF MILAN
International Registry of Rare Bleeding Disorders
CENTER DATA:
Institute/Department:
Responsible Dr/Prof:
E-mail
City
Country
Phone
Fax
Have you any experience with Rare Bleeding Disorders? yes no
If yes, please specify how many patients are registered in you Center:
FACTOR
NUMBER OF PROBANDS
Afibrinogenaemia
Factor II
Factor V
Factor V+VIII
Factor VII
Factor X
Factor XI
Factor XIII
Factor VII+X
Factor V+VII
other combined deficiencies please specify:
Please specify the type of treatment that you usually use in your Center
NAME OF PRODUCTS
>Factor VII+X
>Factor V+VII
Could you please specify if you had any problem during the treatment of your patients? Due to:
Inability to get desired product:
Cost of the product:
No factor concentrate available:
Adverse effects:
Other:
Have you already registered your patients in a National or International database on Rare Coagulation disorders? yes no
If yes please report your registry:
