From the Research
A burning sensation after Factor VIII administration in a hemophilic child requires immediate medical attention as it may indicate an infusion reaction, and the most recent study 1 suggests that new treatment options are available, but the current standard of care should be followed. The child's hematologist or emergency care should be contacted immediately to stop the infusion and assess the situation. This reaction could be due to the rate of infusion being too rapid, so future infusions should be administered more slowly (typically over 5-10 minutes) as suggested by general medical knowledge. Some children benefit from premedication with acetaminophen (10-15 mg/kg) or diphenhydramine (1 mg/kg, maximum 50 mg) 30 minutes before Factor VIII administration. The burning sensation may also indicate early signs of an inhibitor development, which occurs when the body produces antibodies against Factor VIII, a serious complication affecting 20-30% of severe hemophilia A patients and requires specialized treatment protocols 2. Key considerations for managing this condition include:
- Stopping the infusion immediately and seeking medical attention
- Administering future infusions more slowly
- Considering premedication with acetaminophen or diphenhydramine
- Monitoring for signs of inhibitor development and adjusting treatment protocols as needed
- Documenting all reactions and reporting them to the child's hematology team to adjust the treatment regimen. The burning sensation occurs because Factor VIII concentrates can trigger inflammatory mediator release or cause direct vascular irritation when administered too quickly, and the most recent study on hemophilia treatment 1 does not provide specific guidance on this issue, but emphasizes the importance of personalized treatment strategies.