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Bleeding Disorders: Types, Causes, Symptoms, and Treatment

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Bleeding disorders are a group of medical conditions that affect the body's blood clotting mechanics, leading to excessive bleeding or easy bruising.

Medically reviewed by

Dr. Abdul Aziz Khan

Published At March 29, 2023
Reviewed AtFebruary 13, 2024

Introduction

Bleeding disorders are a group of diseases in which a person's blood does not clot as it should. This can lead to prolonged bleeding and bruising, as well as other serious health complications. Bleeding disorders can be genetic or acquired and range in severity from mild to life-threatening.

What Are the Types of Bleeding Disorders?

There are several different types of bleeding disorders, including:

  • Hemophilia: Hemophilia is a genetic bleeding disorder that primarily affects males. It results from the lack or absence of clotting factors VIII or IX, which are essential for blood clotting.

  • Von Willebrand Disease: Von Willebrand disease is a genetic condition that results in bleeding problems in both genders. It happens due to the lack or improper functioning of the von Willebrand factor, which is a protein that assists platelets in adhering to each other and forming blood clots.

  • Thrombocytopenia: Thrombocytopenia is a bleeding disorder caused by low platelet count. Platelets are tiny cells found in the blood that play a crucial role in creating blood clots to prevent bleeding.

  • Platelet Function Disorders: Platelet function disorders are bleeding disorders that occur when platelets do not function properly. This is caused by genetic mutations or certain medications.

  • Disseminated Intravascular Coagulation (DIC): DIC is a medical emergency that can occur as a complication of certain illnesses or injuries. It is characterized by abnormal blood clotting and bleeding throughout the body.

  • Factor Deficiencies: Factor deficiencies are bleeding disorders that occur when the body does not produce enough of a specific clotting factor. This can be caused by genetic mutations or certain medications.

  • Acquired Hemophilia: Acquired hemophilia is a rare bleeding disorder that occurs when the body develops antibodies that attack clotting factors in the blood.

What Are the Causes of Bleeding Disorders?

There are different causes of bleeding disorders, including:

  • Genetic mutations: Some bleeding disorders, such as hemophilia and von Willebrand disease, are a result of genetic mutations that impair the body's ability to produce specific clotting factors or proteins required for blood clotting.

  • Medications: Certain medications, such as blood thinners and antiplatelet drugs, can interfere with the body's ability to clot properly and increase the risk of bleeding.

  • Liver Disease: The liver is responsible for producing many of the proteins and clotting factors necessary for blood clotting. Liver disease or damage can disrupt this process and increase the risk of bleeding.

  • Autoimmune Disorders: Autoimmune disorders, such as lupus and rheumatoid arthritis, can cause the body to produce antibodies that attack and damage blood vessels, leading to bleeding.

  • Cancer: Some types of cancer, particularly blood cancers such as leukemia and lymphoma, can interfere with the body's ability to produce platelets or clotting factors, leading to bleeding disorders.

  • Infections: Certain infections, such as hepatitis C and HIV, can damage the liver or immune system, leading to bleeding disorders.

  • Trauma: Trauma, such as a severe injury or surgery, can disrupt the body's ability to clot properly and increase the risk of bleeding.

What Are the Signs and Symptoms of Bleeding Disorders?

The signs and symptoms of a bleeding disorder can vary depending on the type and severity of the disorder. Some common signs and symptoms include:

  • Easy Bruising: Individuals with bleeding disorders may bruise easily, even from minor bumps or injuries.

  • Excessive Bleeding: People who have bleeding disorders may experience excessive bleeding even from minor wounds or injuries. The bleeding can be hard to control and may persist for a prolonged duration.

  • Nosebleeds: Frequent or prolonged nosebleeds can be a sign of a bleeding disorder.

  • Heavy Menstrual Periods: Women with bleeding disorders may experience heavy or prolonged menstrual periods.

  • Joint Pain and Swelling: Bleeding into joints can cause pain, swelling, and stiffness.

  • Blood in the Urine or Stool: Blood disorders can result in presence of blood in the stool or urine.

  • Fatigue and Weakness: Prolonged or excessive bleeding can lead to fatigue and weakness.

How Are Bleeding Disorders Diagnosed?

In order to identify a bleeding disorder and determine whether it is inherited or acquired, the physician may prescribe one or more of the following examinations.

  • A complete blood count (CBC) evaluates various components of the blood, such as the number of blood cells and platelets. If the number of platelets is low, it could indicate a platelet disorder instead of a clotting factor disorder.

  • A partial thromboplastin time (PTT) test, also known as an activated PTT (aPTT), measures the amount of time it takes for the blood to clot. This examination helps identify whether particular clotting factors are involved.

  • Another test that measures the time it takes for blood to clot is the prothrombin time (PT) test. It measures clotting factors that are not included in the PTT test.

  • The mixing test is used to find out if the bleeding disorder is caused by antibodies that stop clotting factors from working. This can happen when a person has an autoimmune disease or gets hemophilia later in life.

  • Von Willebrand factor (vWF) tests evaluate the quantity and functionality of Von Willebrand factor or the specific type of von Willebrand disease (VWD) a person might have.

  • Clotting factor tests, also referred to as factor assays or coagulation panels, help identify whether particular clotting factors are missing or appear at lower levels than usual, indicating the type and severity of the bleeding disorder. For instance, low levels of clotting factor VIII could indicate hemophilia A.

  • The Bethesda test is used to search for antibodies to factors VIII or IX, whereas factor XIII antigen and activity assays detect factor XIII deficiency.

  • Genetic testing is conducted to determine whether specific genes are the cause of the bleeding disorder. The doctor may refer a patient to a genetic testing specialist.

What Is the Treatment?

The treatment of a bleeding disorder depends on the underlying cause and severity of the condition. Some common treatments for bleeding disorders include:

  • Replacement Therapy: It involves replacing missing or deficient clotting factors with infusions of clotting factor concentrates. This is a common treatment for hemophilia A and B.

  • Desmopressin (DDAVP): It is a medication that stimulates the release of von Willebrand factor and can be used to treat certain types of von Willebrand disease.

  • Antifibrinolytic Medications: Antifibrinolytic medications, such as tranexamic acid, help to prevent the breakdown of blood clots and can be used to treat bleeding in some bleeding disorders.

  • Immune Globulin Therapy: It can be used to treat autoimmune disorders that cause bleeding disorders, such as acquired hemophilia.

  • Surgery: Surgery may be necessary to stop bleeding or prevent future bleeding in certain cases, such as joint bleeding in severe hemophilia.

Is It Possible to Prevent Bleeding Disorders?

It is not possible to prevent inherited bleeding disorders like inherited or acquired hemophilia and von Willebrand disease. However, couples who are conscious of the possibility of having a child with a bleeding disorder may opt to seek advice from a genetic counselor before making plans to start a family. This can help provide information and answer questions about the risks associated with the condition. Newborns are at risk of developing vitamin K deficiency bleeding. In order to prevent this type of bleeding disorder, infants are usually given a vitamin K injection soon after birth.

Conclusion

In conclusion, bleeding disorders are a group of medical conditions that affect the body's ability to form blood clots, leading to excessive bleeding or easy bruising. These disorders can have various causes and symptoms and can be diagnosed through various examinations such as the CBC, PTT, PT, mixing test, clotting factor tests, and the Bethesda test. Early diagnosis and appropriate management of bleeding disorders are crucial to preventing serious health complications and improving patients' quality of life.

Dr. Abdul Aziz Khan
Dr. Abdul Aziz Khan

Medical oncology

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