Bleeding diathesis
| Bleeding diathesis | |
|---|---|
| Specialty | Hematology  |
In medicine (hematology), bleeding diathesis (or bleeding tendency or predisposition or ha(e)morrhagic diathesis) is an unusual susceptibility to bleeding (hemorrhage) mostly due to hypocoagulability, in turn caused by a coagulopathy (a defect in the system of coagulation). Several types are distinguished, ranging from mild to lethal. Also, bleeding diathesis can be caused by thinning of the skin or impaired wound healing.
Hypocoagulability
Hypocoagulability is a bleeding diathesis caused by coagulopathy.
Causes
While there are several possible causes, they generally result in excessive bleeding and a lack of clotting.
Acquired
Acquired causes of coagulopathy include anticoagulation with warfarin, liver failure, Vitamin K deficiency and disseminated intravascular coagulation.
Additionally, the haemotoxic venom from certain species of snakes can cause this condition, for example Bothrops, rattlesnakes and other species of viper. Viral hemorrhagic fevers include dengue hemorrhagic fever and Dengue Shock Syndrome
Leukemia may also cause coagulopathy.
Autoimmune causes of acquired coagulation disorders
There are autoimmune causes of coagulation disorders. They include acquired antibodies to coagulation factors, termed inhibitors of coagulation. The main inhibitor is directed against clotting Factor VIII. Another example is antiphospholipid syndrome an autoimmune, hypercoagulable state.
Genetic
Some people lack genes that typically produce the protein coagulation factors that allow normal clotting. Various types of Hemophilia and von Willebrand disease are the major genetic disorders associated with coagulopathy.
Rare examples are Bernard-Soulier syndrome, Wiskott-Aldrich syndrome and Glanzmann's thrombasthenia.
Generally if one parent has a type of Bleeding Diathesis it there is a 95% chance of passing onto their offspring. [citation needed]
Symptoms
| Symptom | Disorders |
|---|---|
| Petechiae (red spots) |
|
| Purpura and ecchymoses | |
| Blood in stool |
|
| Bleeding gingiva (gums) | |
| Prolonged nose bleeds |
|
Complications
Following are some complications of coagulopathies, some of them caused by their treatments:
| Complication | Disorders |
|---|---|
| Soft tissue bleeding, e.g. deep-muscle bleeding, leading to swelling, numbness or pain of a limb. | |
| Joint damage, potentially with severe pain and even destruction of the joint and development of arthritis |
|
| Retinal bleeding |
|
| Transfusion transmitted infection, from blood transfusions that are given as treatment. |
|
| Adverse reactions to clotting factor treatment. |
|
| Anemia | |
| Exsanguination (bleeding to death) |
|
| Cerebral hemorrhage |
Comparing coagulation tests
Causes other than coagulation
Bleeding diathesis may also be caused by impaired wound healing (as in scurvy), or by thinning of the skin, such as in Cushing's syndrome .
References
- ^ a b c d e Wiskott-Aldrich Syndrome The International Patient Organisation for Primary Immunodeficiencies (IPOPI).
- ^ a b c d e f g h i Disorders of thrombosis and hemostasis: clinical and laboratory practice. Page Rodger L. Bick. Edition 3, illustrated. ISBN 0-397-51690-8, ISBN 978-0-397-51690-2. 446 pages
- ^ a b c Vitamin K Deficiency eMedicine. Author: Pankaj Patel, MD. Coauthor(s): Mageda Mikhail, MD, Assistant Professor. Updated: Dec 18, 2008
- ^ a b c d Hemophilia Complications By Mayo Clinic staff. May 16, 2009
- ^ a b c d Von Willebrand disease --> Complications By Mayo Clinic staff. Feb. 7, 2009
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