Splenomegaly after intensive treatment of hemophilia.

The article by Levine et al.1 concerning abnormal liver chemistries and splenomegaly in intensively treated hemophiliacs left both observations unexplained. Although their literature search “revealed no reports of splenomegaly associated with hemophilia,” I would like to call attention to a 1966 report from our clinic on therapy of hemophilia with fraction I in which splenomegaly was observed and the cause explained.2 The fraction I used contained contaminating immunoglobulins with anti-A and anti-B isoagglutinins in sufficient titer to cause mild hemolytic anemia in type A or B recipients. Patients who developed hemolytic anemia had splenomegaly, and splenomegaly subsided as hemolysis regressed when fraction I therapy was discontinued. We could not relate hemolysis to the high fibrinogen levels present after fraction I. Fractions currently used for factor