• 1 year-old boy with severe <1% FVIII deficient hemophilia
• Diagnosed via cord blood testing due to family history
–Maternal grandfather and brother (brother has an inhibitor)
–Genetic defect: inversion mutation
• 2 months of age: developed right knee/thigh bleed
–First exposure to factor concentrate
–Required 4 days of infusion
–Complete resolution of bleeding event
• 3 months of age: developed 2nd right knee/thigh bleed
–Required 9 days of infusion
• 6 months of age: admitted to hospital for a 3rd right knee bleed
–Unable to achieve adequate FVIII levels despite continuous infusion of factor FVIII concentrate
–Diagnosed with 6 Bethesda Unit (BU) inhibitor and started on bypassing agents (administered via central line)