Clotting Disorders Bleeding Disorders

Overview, Causes, & Risk Factors

Bleeding disorders include a wide range of medical problems that lead to poorblood clotting and excessive bleeding.

What is going on in the body?

Blood clotting occurs when blood changes from a liquid to a semisolid state.Normal blood clotting should occur after trauma that causes bleeding. Withinseconds of an injury, tiny cells in the blood, called platelets, bunch togetherat the site of the wound. Blood proteins, platelets, calcium, and other tissuefactors react together and form what is called a clot. A clot acts like a netover the wound.Over the next several days to weeks, the clot strengthens, then dissolves whenthe wound is healed.

Bleeding disorders occur when the blood cannot clot normally. These disorderscan be present at birth or be acquired from other conditions.

What are the causes and risks of the condition?

There are many causes of bleeding disorders. Some examples of causes include:

  • bone marrow disorders
  • cancer, such as leukemia
  • disseminated intravascular coagulation, whichis a condition in which the body’s clotting system functions abnormally
  • pregnancy-associated eclampsia, also known as severe toxicity ofpregnancy
  • exposure to snake venom
  • hemophilia A and B, which are inherited blood disorders
  • immune system disorders, such as allergic reactions to medicine or abnormal reactions to aninfection
  • liver disease
  • medicines used as blood thinners, such as aspirin, heparin, andwarfarin
  • medicines used to break up blood clots
  • organ transplant rejection
  • von Willebrand disease, which is an inherited blooddisorder
  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    Bleeding disorders can range from mild to severe. Mild disorders may not evenbe noticed. Symptoms of mild clotting problems can include:

  • bruising easily
  • heavy menstrualperiods
  • occasional nosebleeds
  • problems with unexpected bleeding after surgery
  • Severe bleeding disorders usually do not occur before birth but can causeproblems at birth. These problems can include:

  • bleeding into joints with minimum trauma
  • bruising easily
  • other life-threatening bleeding
  • spontaneous internal bleeding
  • Some clotting problems cause immediate bleeding, while others result inbleeding several days after trauma or surgery.

    Diagnosis & Tests

    How is the condition diagnosed?

    Diagnosis of a bleeding disorder begins with a history andphysical exam. Blood tests are essential in diagnosing suspected bleedingdisorders. These include a complete blood count (CBC),clotting studies, and chemistry tests. More detailed tests can be done ifthese tests indicate one or more defects.

    Prevention & Expectations

    What can be done to prevent the condition?

    Genetic defects cannot be prevented. Medical conditions that cause clottingproblems are sometimes preventable. Correct use of anticoagulant medicines isimportant. Major advances in the treatment of infections, organ transplants,and cancer can help prevent some cases. Special surgery techniques andmedicines to stop bleeding can also minimize problems from bleeding disorders.

    What are the long-term effects of the condition?

    Mild clotting problems usually have no long-term effects. They may becomeevident only with major surgery. More severe problems may require lifelongtreatment. These can cause fatal bleeding as well as a need for close medicaland surgical monitoring.

    Chronic or serious bleeding problems have many risks, including:

  • chronic anemia, or a lowred blood cell count
  • neurological or psychiatric problems
  • scarring of the joints
  • visual impairments frombleeding into the eye
  • What are the risks to others?

    In general, bleeding disorders are not contagious and pose no riskto others.Some bleeding problems are related to infections that may be contagious. Forexample, HIV, some upper respiratory infections,hepatitis, and infectious mononucleosis (“mono”) can occasionallylead to bleeding problems.

    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment can include:

  • aminocaproic acid to stabilize abnormal immature blood clots
  • intravenous drugs such as vasopressin or desmopression (DDAVP) to correctplatelet defects
  • medicines to reverse excessive bleeding
  • patches that contain thrombin to treat excess bleeding
  • transfusions of blood components, such as platelets
  • Treatment of the associated or underlying illness might include intravenousgamma globulin, corticosteroids, chemotherapy, and various treatments forinfection. Treatment for bleeding disorders can be simple or complex and oftenrequires a team of medical specialists.

    What are the side effects of the treatments?

    Transfusion of blood components can cause a transfusion reaction. This reactioncan include fever, skinrash, destruction of red blood cells, or severe allergic reactions. Transfusion also carries avery small risk of infection with serious diseases, such as HIV and hepatitis. All medicines have sideeffects, such as allergic reactions and stomach upset. Specific sideeffects depend on the medicine used.

    What happens after treatment for the condition?

    Some people may need repeated transfusions or infusions ofmedicine.

    How is the condition monitored?

    The individual will have repeat visits to the healthcare provideruntil the blood disorder is resolved. The provider may order regular bloodtests. Any new or worsening symptoms should be reported to the healthcareprovider.

    Article type: xmedgeneral