Causes Of Bleeding Diathesis: Symptoms, Diagnosis And Treatment

A bleeding diathesis is a tendency or an abnormal predisposition to bleeding; by and large, because of hypocoagulability, which is caused due to a fault in the system of coagulation. Various types are distinguished, ranging from mild to life threatening.

There are a host of likely etiological factors for a bleeding tendency; however, they are generally due to excessive bleeding and a deficiency of clotting.

  • Acquired causes: Acquired causes of the condition include anticoagulation with warfarin, a deficiency of vitamin K, a liver failure, and disseminated intravascular coagulation. Furthermore, the hemotoxic venom from certain species of snakes is also known to trigger this condition, for example – rattlesnakes, bothrops, and vipers. Viral hemorrhagic fevers, such as dengue are also important causes. Leukemia is also known to set off coagulopathy.
  • Genetic causes: Some people do not have the genes which are necessary to synthesize the protein coagulation factors which sustain the normal clotting mechanism. The various types of hemophilia and the Von Willebrand disease are the major genetic disorders that are linked to coagulopathy.
    Usually, in case one of the parents has a type of bleeding diathesis, there is a 95 % possibility of him or her passing it on to the child, given that, most genetically acquired bleeding tendencies and coagulopathies are gender-linked, X chromosome disorders.
  • Autoimmune causes: There are autoimmune causes for coagulation disorders – acquired anti-bodies to coagulation factors, known as inhibitors of coagulation. The main inhibitor is directed against clotting Factor VIII. Anti-phospholipid syndrome is an autoimmune, hyper-coagulable state.

Symptoms Of Bleeding Diathesis

Commonly seen manifestations and clinical features for bleeding diathesis are:

  • Bruising occurs spontaneously and / or recurrently. There could be big bruises on your sun exposed parts and the trunk, are more indicative of a bleeding disorder.
  • Prolonged bleeding occurs after minor cuts, scrapes or abrasions.
  • Nosebleeds occur very frequently; what’s more, they tend to last for more than 10 minutes, despite applying compression to the nose. This is common in one who has Wiskott-Aldrich syndrome.
  • Severe menorrhagia causing anemia, with a sonogram showing a normal uterus.
  • Excessive bleeding from the gums after a dental extraction. There may be undue bleeding from the gums even without any gingival disease and may be even unrelated to brushing and flossing. It may be due to acute or chronic leukamia.
  • Severe post-partum hemorrhage.
  • Blood in stool.
  • Bleeding after injections or a surgery.
  • Red spots or petechiae, purpura and ecchymosis are seen in acute leukamia, chronic leukamia and vitamin K insufficiency.

Diagnosis And Treatment Of Bleeding Diathesis

You need to consult with your health care provider immediately to manage your condition successfully. It is important to establish the precise cause for the bleeding and start prompt treatment. Your doctor will ask you to do a battery of tests to understand your case better. Usually, the following investigations are essential:

  • Full blood count
  • Blood film
  • Platelet count
  • Bone marrow biopsy
  • Liver function test
  • Activated partial thromboplastin time (APTT)
  • Prothrombin time
  • Vitamin K profile
  • Thrombin clotting time
  • Bleeding time
  • Gene analysis

Treatment depends up on the underlying condition and regular follow up visits are very crucial. Whilst the gender-linked nature of hemophilia results in generally in male sufferers, females are more expected to present with mild bleeding disorders due to the demands of menstruation and childbirth.

Those having serious inherited bleeding disorders may wish for prenatal diagnosis and genetic counseling.

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