Haemophilia in European royalty

• Victoria, German Empress (1840–1901) Issue: Wilhelm II of Germany, Charlotte, Duchess of Saxe-Meiningen, Prince Henry of Prussia, Prince Sigismund of Prussia, Viktoria, Princess Adolf of Schaumburg-Lippe, Prince Waldemar of Prussia, Sophia, Queen of the Hellenes, Margaret, Landgravine of Hesse-Kassel
• Edward VII, King of the United Kingdom (1841–1910) Issue: Prince Albert Victor, Duke of Clarence and Avondale, George V, Louise, Princess Royal, Princess Victoria, Maud, Queen of Norway, Prince Alexander John
• Princess Alice, Grand Duchess of Hesse and by Rhine (1843–1878) Issue: Victoria Mountbatten, Marchioness of Milford Haven, Grand Duchess Elizabeth Feodorovna of Russia, Irene, Princess Henry of Prussia, Ernest Louis, Grand Duke of Hesse and by Rhine, Prince Friedrich, Alexandra Feodorovna, Empress of Russia, Princess Marie of Hesse and by Rhine
• Prince Alfred, Duke of Saxe-Coburg and Gotha (1844–1900) Issue: Alfred, Hereditary Prince of Saxe-Coburg and Gotha, Marie, Queen of Romania, Grand Duchess Victoria Feodrovna of Russia, Alexandra, Princess of Hohenlohe-Langenburg, Princess Beatrice, Duchess of Galliera
• Helena, Princess Christian of Schleswig-Holstein (1846–1923) Issue: Prince Christian Victor, Albert, Duke of Schleswig-Holstein, Princess Helena Victoria, Princess Marie Louise, Prince Harald
• Princess Louise, Duchess of Argyll (1848–1939) No issue
• Prince Arthur, Duke of Connaught and Strathearn (1850–1942) Issue: Margaret, Crown Princess of Sweden, Prince Arthur of Connaught, Lady Patricia Ramsay
• Prince Leopold, Duke of Albany (1853–1884) Issue: Princess Alice, Countess of Athlone, Charles Edward, Duke of Saxe-Coburg and Gotha
• Beatrice, Princess Henry of Battenberg (1857–1944) Issue: Alexander Mountbatten, 1st Marquess of Carisbrooke, Victoria Eugenie, Queen of Spain, Lord Leopold Mountbatten, Prince Maurice of Battenberg

Alice (1843–1878), Victoria's third child, and wife of the future Grand Duke Louis IV of Hesse and by Rhine (1837–1892), passed it on to at least three of her children: Irene, Friedrich, and Alix.

• Princess Victoria of Hesse and by Rhine (1863–1950), later Marchioness of Milford Haven, wife of Prince Louis of Battenberg (1854–1921) and maternal grandmother to Prince Philip, Duke of Edinburgh, apparently was not a carrier.
• Princess Elizabeth of Hesse and by Rhine (1864–1918), later Grand Duchess Elizabeth Feodorovna of Russia through her marriage to Grand Duke Sergei Alexandrovich (1857–1905), may or may not have been a carrier. Following her husband's assassination, she became a nun and was childless when killed by the Bolsheviks in 1918.
• Princess Irene of Hesse and by Rhine (1866–1953), later Princess Heinrich of Prussia, through her marriage to Prince Heinrich of Prussia (1862–1929), passed it on to two of her three sons:
  • Prince Waldemar of Prussia (1889–1945). Survived to age 56; had no issue.
  • Prince Heinrich of Prussia (1900–1904). Died at age 4.
• Prince Friedrich of Hesse and by Rhine (1870–1873). Died before his third birthday of bleeding on the brain resulting from a fall from a third-story window (which would almost certainly have not been fatal if he had not had haemophilia).
• Princess Alix of Hesse and by Rhine (1872–1918), later Empress Alexandra Feodorovna of Russia through her marriage to Tsar Nicholas II (1868–1918). Alix had a marriage proposal from her first cousin, Prince Albert Victor (1864–1892), eldest son of the then Prince of Wales (later King Edward VII); had she accepted, haemophilia could have returned to the direct line of succession in the United Kingdom.
  • Grand Duchess Maria Nikolaevna (1899–1918), Nicholas and Alexandra's third daughter, was thought by some to have been a symptomatic carrier because she haemorrhaged during a tonsillectomy.^[3] DNA testing of the Romanov family remains in 2009 showed that one of the four daughters, thought to be Maria by American researchers and Anastasia by Russian researchers, was a carrier.^[1]
  • Tsarevich Alexei (1904–1918) was murdered with his family by the Bolsheviks at the age of 13. Alexei's haemophilia was one of the factors contributing to the collapse of Imperial Russia during the Russian Revolution of 1917.^[4]
• Princess Marie of Hesse and by Rhine (1874–1878), Alice's seventh and last child, may or may not have been a carrier. She died of diphtheria at the age of four.

Leopold (1853–1884), Victoria's eighth child, was the first member of the family to manifest haemophilia; he died at age 30 from bleeding after a minor fall,^[5] only two years after marrying Princess Helen of Waldeck and Pyrmont (1861–1922).

He passed the gene on to his only daughter:

• Princess Alice of Albany (1883–1981), later Countess of Athlone, who in turn passed it on to her elder son:
  • Prince Rupert of Teck (1907–1928), later Rupert Cambridge, Viscount Trematon, who died at age 20, bleeding to death after a car accident.

Alice's younger son Prince Maurice of Teck died in infancy, so it is not known if he was a carrier of the gene. Her daughter Lady May Abel Smith (1906–1994), Leopold's granddaughter, has living descendants none of whom has been known to have or to transmit haemophilia.

Leopold's posthumous son, Charles Edward (1884–1954), was unaffected, as a father cannot pass the gene to a son.

Beatrice (1857–1944), Victoria's ninth and last child, and wife of Prince Henry of Battenberg (1858–1896) passed it on to at least two, if not three, of her four children:

• Princess Victoria Eugenie of Battenberg (1887–1969), later Queen Victoria Eugenia of Spain through her marriage to King Alfonso XIII (1886–1940), who passed it on to:
  • Infante Alfonso, Prince of Asturias (1907–1938). Died at age 31, bleeding to death after a car accident.
  • Infante Gonzalo (1914–1934). Died at age 19, bleeding to death after a car accident.
  • Victoria Eugenie's two daughters, Infantas Beatriz (1909–2002) and Maria Cristina of Spain (1911–1996), both have living descendants none of whom has been known to have or to transmit haemophilia.
• Prince Leopold of Battenberg (1889–1922); later Lord Leopold Mountbatten. Died at age 32 during a hip operation.
• Prince Maurice of Battenberg (1891–1914). Killed in action in World War I at the age of 23. Maurice's haemophilia is disputed by various sources: It seems unlikely that a known haemophiliac would be allowed to serve in combat.

No living member of the present or past reigning dynasties of Europe is known to have symptoms of haemophilia or is believed to carry the gene for it. The last descendant of Victoria known to have the disease was Infante Gonzalo, born in 1914, although hundreds of descendants of Queen Victoria's (including males descended only through females) have been born since 1914. However, because the haemophilia gene usually remains hidden in females who only inherit the gene from one parent, and female descendants of Victoria have left many descendants in royal and noble families, there remains a small chance that the disease could appear again, especially among the female-line Spanish descendants of Princess Beatrice.^[why?]

Queen Victoria died in 1901 and outlived her youngest son and a grandson, both of whom had the disease. The gene can be passed down the female line without a haemophiliac son being born, but as the family line continues and no haemophiliac sons are born, it becomes less likely that a certain ancestor had the gene and passed it on through the female line.

Because the last known descendant of Queen Victoria with haemophilia died a few months before the end of WWII, in 1945, the exact type of haemophilia found in this family remained unknown until 2009. Using genetic analysis of the remains of the assassinated Romanov dynasty, and specifically Tsarevich Alexei, Rogaev et al. were able to determine that the "Royal Disease" is actually haemophilia B. Specifically, they found a single-nucleotide change in the gene for clotting Factor IX that causes incorrect RNA splicing and produces a truncated, nonfunctional protein.^[6]

• Potts, D. M. Queen Victoria's Gene. Sutton Publishing, 1999. ISBN 0-7509-1199-9.
• "Hemophilia: The Royal Disease" Yelena Aronova-Tiuntseva and Clyde Freeman Herreid
• Family tree of Queen Victoria and her descendants
• Haemophilia in Queen Victoria's Descendants. Archived 2006-11-18 at the Wayback Machine
• Victor A. McKusick (August 1965). "The Royal Hemophilia". Scientific American. pp. 88–95. Retrieved 25 August 2022.