Abdul Mannan/LinkedIn

May 17, 2026, 16:34

Abdul Mannan: A Normal Factor Level Can Still Miss the Story

Abdul Mannan, Consultant Haematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn:

“A normal factor level can still miss the story.

That is the false reassurance trap in haemophilia carriers.

The lab result matters. Of course it does. But it should never be used as a permission slip to ignore bleeding symptoms.

Here’s what I want every trainee to remember:

FVIII and FIX levels are risk clues
Bleeding history is a clinical signal
Heavy periods, nosebleeds, oral bleeding, bruising, procedure bleeding, and joint pain all matter
A structured BAT or HMB screen can change the conversation
Symptomatic carriers need a documented plan and review
Haemophilia Carrier Post 1 of 8

One number rarely explains the whole patient.

The better question is not, ‘Is the factor level normal?’

The better question is, ‘Does the bleeding phenotype fit the life this patient is living?’

That small change can stop years of reassurance without action.

What phrase do you use in clinic to move from ‘normal result’ to ‘proper bleeding assessment’?”

Abdul Mannan: A Normal Factor Level Can Still Miss the Story