Bleeding diathesis is a term describing a propensity toward bleeding or hemorrhage, which can be a constitutive feature of numerous disorders of vascular, genetic, or autoimmune origin. The diagnosis rests on identifying the underlying cause through a detailed patient history and laboratory workup.
The clinical presentation of bleeding is diverse, and it is imperative to recognize different forms of bleeding that may provide vital information about the underlying cause. Cutaneous (petechiae, epistaxis, purpuric spots, ecchymosis) or mucosal bleeding (for eg. gingival or conjunctival bleeding) rises suspicion toward platelet disorders (such as thrombotic thrombocytopenic purpura (TTP), splenic sequestration or drug-induced thrombocytopenia) and vascular abnormalities  . Muscular, parenchymal, intracavitary (hemoperitoneum, hemothorax), or orificial bleeding can point to disorders of impaired coagulation, including hemophilia A and B, vitamin K deficiency, celiac disease, von Willebrand disease (vWD) and many other   . In fact, a tendency towards bleeding can be the first manifestation of patients with celiac disease (CD) . In addition to the type of bleeding, signs such as excessive hemorrhage from cuts, easy bruising or intracranial bleeding may suggest some form of coagulopathy as well (vitamin K deficiency or any of the inherited genetic disorders)  . Menorrhagia, especially when present in younger women, is a diagnostic hallmark of bleeding disorders in this population. The onset of bleeding is also an important clue, as bleeding diathesis may last throughout the entire childhood or just for a few days, depending on the underlying cause. Hepatosplenomegaly, tachycardia, skin or conjunctival pallor, and anemia presenting with a heart murmur are other notable symptoms. In very rare cases, eczema and recurrent infections accompanied by frequent bleeding episodes are highly specific for Wiskott-Aldrich syndrome, an X-linked genetic disease .
Entire Body System
When amyloidosis does cause a coagulopathy, it is most often acquired factor X deficiency, but there are rare reports of amyloidosis being associated with other acquired factor deficiencies. [ncbi.nlm.nih.gov]
Abstract Hemorrhagic manifestations occur frequently in amyloidosis (1, 2). In isolated instances hypoprothrombinemia (3) or hypofibrinogenemia (4) may be responsible for major bleeding difficulties. [annals.org]
[…] caused by a defect in clotting or a flaw in the structure of blood vessels, as in hemophilia, purpura, scurvy, or vitamin K deficiency. 2, record 1, English, - hemorrhagic%20diathesis Record number: 1, Textual support number: 1 OBS Can be seen in primary amyloidosis [btb.termiumplus.gc.ca]
- Coarctation of the Aorta
Cardiac anomalies such as coarctation of the aorta, pulmonary valve stenosis, hypertrophic cardiomyopathy, and septal defects are present in more than half of patients. Dysplasia of the pulmonic valve has been reported as well. [disorders.eyes.arizona.edu]
- Easy Bruising
Conclusions: Easy bruising was the most common presenting symptom for which patients were referred to hematology. [ashpublications.org]
bruising, prolonged epistaxis, excessive bleeding after a tooth extraction). [orpha.net]
Nine of our patients indicated a relevant bleeding diathesis and complained of easy bruising, three reported spontaneous gum bleeding. [ncbi.nlm.nih.gov]
In addition to the type of bleeding, signs such as excessive hemorrhage from cuts, easy bruising or intracranial bleeding may suggest some form of coagulopathy as well (vitamin K deficiency or any of the inherited genetic disorders). [symptoma.com]
Results: A total of 92 children up to the age of 14 years were taken up for study, of which, maximum cases with bleeding presented with hematemesis (23.9%) followed by melena (22.8%). [atharvapub.net]
Signs: Abnormal Bleeding (multiple sites) Nasopharynx Epistaxis Bleeding Gums Gastrointestinal Hematemesis Melana Gynecologic Menorrhagia Postpartum Hemorrhage Musculoskeletal Muscle hematomas Hemarthrosis Skin Purpura Petechiae Trauma Excessive bleeding [fpnotebook.com]
A 40-year-old woman with epistaxis, hematemesis, and altered mental status. Martha E Laposata, Elizabeth M. Van Cott, Michael H. Lev The New England journal of medicine 2007 3 Excerpts Celiac disease. Peter H. R. [semanticscholar.org]
Case Presentation An 18-year-old unmarried young Asian female came through the emergency department (ER) with a history of hematemesis for last twenty-four hours. The patient reported that this was the third episode of hematemesis in one day. [cureus.com]
Face, Head & Neck
Epistaxis is a common and difficult problem to manage in patients with bleeding disorders. [ncbi.nlm.nih.gov]
Presenting symptoms in rare inherited platelet disorders were purpura, ecchymosis, epistaxis and bleeding gums, respectively. [journals.lww.com]
This episode had been preceded by one day of epistaxis, abdominal pain, hematuria, and the passage of maroon stools. The patient denied a. .. Mark C. Weinrobe, M.D. Bruce Montgomery, M.D. [nejm.org]
He did have persistent hematuria following the ureteroscopy, which was managed with platelet transfusion and fresh frozen plasma. [indianjurol.com]
Hematoloji, Kayseri 2Erciyes Üniversitesi Tıp Fakültesi Nefroloji, Kayseri 3Erciyes Üniversitesi Tıp Fakültesi İç Hastalıkları, Kayseri Herein, we report a 22 year-old female patient who had complaints of petechiae at the lower extremity, ecchymoses, hematuria [erciyesmedj.com]
She had a history of recurrent and prolonged bleeding such as mild epistaxis, gingival bleeding and microscopic hematurias. She also experienced a severe bleeding event after surgery. [spandidos-publications.com]
Gastrointestinal bleeding None/trivial Present (not associated with ulcer, portal hypertension, hemorrhoids, or angiodysplasia) Consultation only† Surgical hemostasis or antifibrinolytic therapy Blood transfusion, replacement therapy, or desmopressin therapy Hematuria [aafp.org]
He had fallen from his cot 5 days earlier and since then had been vomiting and had become irritable. He required intubation due to deteriorating consciousness and poor respiratory effort. [thejns.org]
</li></ul><h2>Complications of a sore throat</h2><p>Sore throats that are caused by viruses, throat clearing, dryness or irritants rarely have any long-term complications. [aboutkidshealth.ca]
A detailed patient history should be obtained in all patients with a bleeding diathesis, as it may reveal key findings such as prior use of aspirin or anticoagulant therapy, a prolonged duration of symptoms and the familial presence of bleeding disorders  . The type and severity of bleeding noted during the physical examination are pivotal as well, but to determine the underlying cause, an extensive laboratory workup is necessary. A complete blood count (CBC) can detect anemia and more importantly thrombocytopenia (defined as platelet count <150,000/μL), which may occur either as a result of impaired function or insufficient production of platelets. Initial workup should also comprise prothrombin time (PT) and activated partial thromboplastin time (aPTT), to determine whether the extrinsic or intrinsic pathway is disturbed . Prolonged PT suggests factor VII deficiency, while hemophilias A and B, Von Willebrand disease, and deficiency of factors XI and XII are the most likely causes of bleeding if aPTT is prolonged . If both extrinsic and intrinsic pathways are defective, vitamin K deficiency, liver disease, use of anticoagulant therapy or deficiency of factors V, X, or II must be considered in the differential diagnosis . Additional procedures include a peripheral blood smear, platelet function analysis (PFA), thrombin time, inflammatory parameters (erythrocyte sedimentation rate, C-reactive protein, fibrinogen and D-dimer), as well as the determination of individual coagulation factors  .
Due to multiple comorbidities, it may be impossible to safely discontinue the anticoagulant treatment. Other modalities such as shock wave lithotripsy and PCNL are contraindicated in these patients, so ureteroscopic treatment may be the only option. [ncbi.nlm.nih.gov]
From these treatments, patients may experience anemia, cerebral hemorrhage, or soft tissue bleeding. Other immediate treatments include prolonged bleeding from the nose with gauze and a packed dressing. [doctorshealthpress.com]
Relatively favorable prognosis. With age, the tendency to bleeding is reduced. Mortal danger may be profuse bleeding and bleeding into vital organs. [eurodoctor.ucoz.com]
Some bleeding disorders have a better prognosis if they’re treated early. It’s especially important to see a doctor about a bleeding disorder if you expect to have surgery, give birth, or have extensive dental work. [healthline.com]
KEYWORDS: Blood coagulation disorders/complications; blood coagulation factors/inhibitors; central nervous system diseases/etiology; hemophilia A; hemophilia B; hemorrhage; hemorrhage/etiology; humans intracranial hemorrhages/etiology; platelet transfusion [ncbi.nlm.nih.gov]
Disease-oriented chapters include etiology, differential diagnosis, history, physical examination, laboratory and imaging studies, treatment, and special considerations during pregnancy. [books.google.com]
Analysis of the clinico-epidemiological data of patients with bleeding disorders is a useful tool for monitoring and improving their quality of care. [ncbi.nlm.nih.gov]
We aimed to assess the prevalence of various bleeding disorders including rare inherited coagulation and platelet disorders concerning their clinico-epidemiological, diagnostic data and bleeding manifestations severity. [journals.lww.com]
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
Disseminated intravascular coagulation Impaired hepatic production of coagulation factors: e.g., liver cirrhosis Other important types Von Willebrand disease Definition: : a disorder of primary hemostasis characterized by either a deficiency or disorder of vWF Epidemiology [amboss.com]
Congenital FV deficiency (Owren parahaemophilia) Epidemiology Congenital FV deficiency (OMIM #227400), first described by Owren (1947) (Stormorken, 2003), is an autosomal recessive bleeding disorder that reportedly affects 1:106 individuals in the general [onlinelibrary.wiley.com]
Kwaan Springer Science & Business Media, ٢١/٠٤/٢٠٠٩ - 339 من الصفحات Coagulation in Cancer informs professionals working in the field of cancer about the pathophysiologic mechanisms of cancer-related thrombosis and bleeding. [books.google.com]
Variants of von Willebrand disease Type Inheritance/etiology Pathophysiology Congenital Type 1 (80%) Autosomal dominant Quantitative deficiency of vWF and factor VIII Type 2 (15-20%) Autosomal dominant Qualitative defect in vWF Type 3 (∼ 1%) Autosomal [amboss.com]
Several pathophysiological mechanisms underlie TIC; tissue injury and shock synergistically provoke endothelial, immune system, platelet and clotting activation, which are accentuated by the 'lethal triad' (coagulopathy, hypothermia and acidosis). [portailvasculaire.fr]
Such pathophysiology significantly stresses even an initially normal hemostatic mechanism. It is not surprising, then, that bleeding is a frequent complication encountered in the intensive care setting. [link.springer.com]
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Bleeding problems may be associated with a wide variety of coagulation abnormalities or may be due to problems not associated [mayomedicallaboratories.com]
Getting prompt treatment will help prevent any potential complications. [healthline.com]
We present a case of recurrent epistaxis in a patient with Bernard-Soulier syndrome (a platelet disorder) and describe a non-invasive but effective method of closing the nasal vestibule using a silastic obturator thus preventing the drying effects of [ncbi.nlm.nih.gov]
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- Kasatkar P, Shetty S, Ghosh K. Delayed vitamin K deficiency as a cause of bleeding: still a concern in the 21st century! Blood Coagul Fibrinolysis. 2010;21(6):608-610.
- Dizdar O, Onal IK, Ozakin E, et al. Research for bleeding tendency in patients presenting with significant epistaxis. Blood Coagul Fibrinolysis. 2007;18(1):41-43.