| name: | Bleeding Disorder |
| also known as: | Bleeding Problem |
| also see: | Hemophilia; von Willebrand's disease; Coagulation Test; Hypercoagulable States; Thrombocytopenia; Thrombocytosis; Afibrinogenemia; Bleeding Time; ICD |
| description: | The classic bleeding disorder is called hemophilia. Other causes of bleeding can include thrombocytopenia, thrombocytosis, afibrinogenemia, vitamin K deficiency, DIC, cirrhosis of the liver, liver failure, starvation, malnutrition, aspirin, NSAID, and other drugs, chronic renal failure, drugs designed to prolong bleeding such as anticoagulation drugs and antiplatelet drugs, acute leukemia, chronic leukemia, and other related blood cancers and blood disorders, fibrinolytics. The four categories of bleeding are: 1. platelet dysfunction - thrombocytopenia, thrombocytosis, von Willebrand syndrome, aspirin, NSAID, antiplatelet drugs, anticoagulation drugs and other drugs 2. coagulation factor dysfunction - hemophilia, vitamin K deficiency, cirrhosis of the liver, afibrinogenemia, von Willebrand's disease 3. fibrin dysfunction - fibrinolytics, afibrinogenemia 4. connective tissue dysfunction - amyloidosis, Cushing's syndrome, Osler-Weber-Rendu syndrome, vitamin C deficiency, Ehlers-Danlos syndrome, Ataxia Telangiectasia syndrome |
| signs & symptoms: | Platelet bleeding disorders are associated with immediate bleeding in relationship to injury, trauma, surgery usually involving mucous membranes and skin. Coagulation bleeding disorders are associated with delayed bleeding, many hours and usually several days after injury, trauma, or surgery usually involving deeper soft tissues and joints. Classic signs and symptoms of a bleeding problem include severe and recurrent nose bleeds, bleeding into joints, menorrhagia, bleeding after tooth extraction, easy bruisability, gum bleeding, spontaneous bleeding with no apparent trauma, bruising in odd places, large bruises out of proportion to the trauma, prolonged resolution of bruises. |
| diagnosis: | Four key diagnostic tests to order are: PT, PTT, blood count w/ platelets and a bleeding time. Abnormal PT normal PTT think: factor VII, vitmain K deficiency, coumadin, cirrhosis of the liver. Abnormal PTT normal PT think: factor VIII, factor IX, factor XI, von Willibrand. Abnormal PT abnormal PTT think: multiple factor deficiencies, cirrhosis of the liver, disseminated intravascular coagulation, and on rare occasion, deficiencies of factor II, factor V, factor X, fibrinogen. Prolonged bleeding time think von Willibrand, platelet dysfunction, afibrinogenemia, disseminated intravascular coagulation, myeloproliferative disorder, chronic renal failure, heavy chain disease. Bleeding disorders that can occur with all normal lab tests think: von Willibrand. Less likely includes factor XIII, and connective tissue problems. |
Last updated 6/28/2009