|Classification and external resources|
In medicine (hematology), bleeding diathesis (h(a)emorrhagic diathesis) is an unusual susceptibility to bleed (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.
|Petechiae (red spots)|
|Purpura and ecchymoses|
|Blood in stool||
|Bleeding gingiva (gums)|
|Prolonged nose bleeds|
While there are several possible causes, they generally result in excessive bleeding and a lack of clotting.
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. Furthermore, cystic fibrosis has been known to cause bleeding diathesis, especially in undiagnosed infants, due to malabsorption of fat soluble vitamins like Vitamin K.
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.
Causes other than coagulation
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.
Comparing coagulation tests
|Condition||Prothrombin time||Partial thromboplastin time||Bleeding time||Platelet count|
|Vitamin K deficiency or warfarin||Prolonged||Normal or mildly prolonged||Unaffected||Unaffected|
|Disseminated intravascular coagulation||Prolonged||Prolonged||Prolonged||Decreased|
|Von Willebrand disease||Unaffected||Prolonged or unaffected||Prolonged||Unaffected|
|Liver failure, early||Prolonged||Unaffected||Unaffected||Unaffected|
|Liver failure, end-stage||Prolonged||Prolonged||Prolonged||Decreased|
|Factor V deficiency||Prolonged||Prolonged||Unaffected||Unaffected|
|Factor X deficiency as seen in amyloid purpura||Prolonged||Prolonged||Unaffected||Unaffected|
|Bernard-Soulier syndrome||Unaffected||Unaffected||Prolonged||Decreased or unaffected|
|Factor XII deficiency||Unaffected||Prolonged||Unaffected||Unaffected|
Following are some complications of coagulopathies, some of them caused by their treatments:
|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||
|Transfusion transmitted infection, from blood transfusions that are given as treatment.|
|Adverse reactions to clotting factor treatment.|
|Exsanguination (bleeding to death)||
- Amin, Chirag; Sharathkumar, Anjali; Griest, Anne (2014-01-01). "Bleeding diathesis and hemophilias". Handbook of Clinical Neurology. 120: 1045–1059. doi:10.1016/B978-0-7020-4087-0.00070-X. ISSN 0072-9752. PMID 24365370.
- Wiskott-Aldrich Syndrome The International Patient Organisation for Primary Immunodeficiencies (IPOPI).
- 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
- Vitamin K Deficiency eMedicine. Author: Pankaj Patel, MD. Coauthor(s): Mageda Mikhail, MD, Assistant Professor. Updated: Dec 18, 2008
- Hemophilia Complications By Mayo Clinic staff. May 16, 2009
- Von Willebrand disease --> Complications By Mayo Clinic staff. Feb. 7, 2009