Bleeding diathesis

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Bleeding diathesis main page

Overview

Classification

Differential Diagnosis

Platelet disorders
Immune Thrombocytopenic Purpura
Thrombotic Thrombocytopenic Purpura
Hemolytic Uremic Syndrome
Thrombocytosis
Von Willebrand Disease
Coagulation disorders
Fibrinogen deficiency
Prothrombin deficiency
Factor V deficiency
Factor VII deficiency
Factor VIII deficiency
Factor IX deficiency
Factor X deficiency
Factor XI deficiency
Factor XII deficiency
High-molecular-weight kininogen deficiency
Prekallikrein deficiency
Factor XIII deficiency
Hemophilia
Rare diseases
Disseminated Intravascular Coagulation
Vitamin K Deficiency

Different types of Von-Willebrand diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mehrian Jafarizade, M.D [2] Nazia Fuad M.D.

Overview

Bleeding diathesis is unusual susceptibility to bleed due to coagulopathies. These diseases can occur due to a disorder of homeostasis, localized process (tissue injury), or medications. Bleeding diathesis can be resulted from vessel wall injury, platelet disorders, and coagulation factor disorders. Clinical manifestation of bleeding disorders can have a wide range of symptoms from no symptom to massive symptomatic and life threatening bleeding. Platelet disorders mostly have skin manifestations such as petechiae, and ecchymoses. In order to find the cause of coagulopathy, there are established laboratory tests that might be used. These laboratory tests such as peripheral blood smear, platelet count and platelet function analysis, coagulation factor deficiencies and inhibitors, fibrinolysis tests (eg. D-dimer level), bleeding time, prothrombin time, activated partial thromboplastin time, thrombin time and reptilase time.

Classification

Differential Diagnosis

Category Sub-category Diseases History Clinical manifestation Laboratory testing
Petechiae Ecchymoses Menorrhagia Hematomas Hemarthrosis platelet count Bleeding time (BT) Prothrombin time (PT) Platelet count activated partial thromboplastin time (aPTT) Thrombin time (TT)
Platelet disorders Thrombocytopenia Infection-Induced Thrombocytopenia + + N N
Medications-Induced Thrombocytopenia History of medications + + N N
Heparin-Induced Thrombocytopenia Trombosis and unexplained thrombocytopenia up to 3 weeks after the end of heparin therapy + +
Immune Thrombocytopenic Purpura (ITP) + + N N
Inherited Thrombocytopenia N N
Thrombotic Thrombocytopenic Purpura (TTP)
Hemolytic Uremic Syndrome N N
Thromobcytosis Digital pain

Gangrene Erythromelalgia

Headache Paresthesias Transient ischemic attacks

+ + ɴormal or slightly prolonged ɴ ɴ
Qualitative Disorders of Platelet Function Inherited Disorders of Platelet Function
Acquired Disorders of Platelet Function
Von Willebrand Disease Easy bruising

Epistaxis

Oral cavity bleeding

Bleeding after dental extraction/surgery

Menorrhagia

Postpartum hemorrhage

+ + + + + Ν
Vessel wall disorders Metabolic and Inflammatory Disorders
Inherited Disorders of the Vessel Wall
Coagulation disorders Fibrinogen deficiency
Prothrombin deficiency
Factor V deficiency
Factor VII deficiency
Factor VIII deficiency
Factor IX deficiency
Factor X deficiency
Factor XI deficiency
Factor XII deficiency
HK deficiency
Prekallikrein deficiency
Factor XIII deficiency
Hemophilia Type A deficiency Eeasy bruising Inadequate clotting in trauma or mild injury spontaneous hemorrhage. hemarthrosis, epistaxis, gingival bleeding _ _ + + + Unaffected Unaffected Unaffected Prolonged N
Type B deficiency Neonatal bleeding

trauma-related soft-tissue hemorrhage

hemarthrosis and hematomas

_ _ + + + Unaffected N N N
Type C deficiency Family history of bleeding disorder,

bleeding after surgry or injury

_ _ + Rare Rare N N N N
Rare diseases Disseminated Intravascular Coagulation Trauma, burn, crush

Sepsis

Malignancy

Obstetric complication: abruption, amniotic fluid embolism

Hemolytic anemia

+ + _ + +
Vitamin K Deficiency Bleeding after trauma, epistaxis, hematoma, gastrointestinal bleeding, menorrhagia, hematuria, gum bleeding, and oozing from venipuncture sites and easy bruisability + + + + + N Normal or mildly prolonged
Coagulation Disorders Associated with Liver Failure
Acquired Inhibitors of Coagulation Factors