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| == Differential Diagnosis ==
| | __NOTOC__ |
| Different causes of the bleeding disorders can be differentiated based on their clinical manifestation and laboratory findings.
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| These features have discussed in the below table:
| | [[Sandbox: wdx]] |
| {|
| | |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
| | [[Xyz]] |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Sub-category
| | |
| ! colspan="2" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases
| | [[Abc]] |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |History
| | # [[Sandbox:Preeti]] |
| ! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestation
| | # [[Lymphoma]] |
| ! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Laboratory testing
| | # [[Breast lumps differential diagnosis]] |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Comments
| | # [[Neck masses differential diagnosis]] |
| | # [[Leukemia]] |
| | {| class="wikitable" |
| | |+ |
| | |- |
| | | colspan="2" |[[:Category:Risk calculator]] |
| | [[Category:Risk calculator]] |
| | |- |
| | | colspan="2" |[[Deep vein thrombosis assessment of clinical probability and risk scores]] |
| | |- |
| | | colspan="2" |[[Pulmonary embolism assessment of clinical probability and risk scores]] |
| | |- |
| | |[[Padua prediction score]] |
| | |[[widget:PaduaVTEscore]] |
| |- | | |- |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mucosal bleeding
| | |[[IMPROVE risk score calculator]] |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Petechia
| | |[[Widget:IMPROVEScore]] |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ecchymoses
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Menorrhagia
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hematoma
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hemarthrosis
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Platelet count
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bleeding time (BT)
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Prothrombin time (PT)
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Activated partial thromboplastin time (aPTT)
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Thrombin time (TT)
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| |- | | |- |
| ! rowspan="14" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet disorders
| | |[[IMPROVEDD risk score calculator]] |
| ! rowspan="7" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Thrombocytopenia]]
| | |[[Widget:IMPROVEDDScore]] |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Infection]]-Induced [[thrombocytopenia]]<span name="harr_c115s002s001s002p001"></span><span name="9100754"></span><ref name="pmid21325604">{{cite journal |vauthors=Neunert C, Lim W, Crowther M, Cohen A, Solberg L, Crowther MA |title=The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia |journal=Blood |volume=117 |issue=16 |pages=4190–207 |date=April 2011 |pmid=21325604 |doi=10.1182/blood-2010-08-302984 |url=}}</ref><ref name="pmid26906627">{{cite journal |vauthors=Karimi O, Goorhuis A, Schinkel J, Codrington J, Vreden SGS, Vermaat JS, Stijnis C, Grobusch MP |title=Thrombocytopenia and subcutaneous bleedings in a patient with Zika virus infection |journal=Lancet |volume=387 |issue=10022 |pages=939–940 |date=March 2016 |pmid=26906627 |doi=10.1016/S0140-6736(16)00502-X |url=}}</ref><ref name="pmid25600600">{{cite journal |vauthors=Zammarchi L, Stella G, Mantella A, Bartolozzi D, Tappe D, Günther S, Oestereich L, Cadar D, Muñoz-Fontela C, Bartoloni A, Schmidt-Chanasit J |title=Zika virus infections imported to Italy: clinical, immunological and virological findings, and public health implications |journal=J. Clin. Virol. |volume=63 |issue= |pages=32–5 |date=February 2015 |pmid=25600600 |doi=10.1016/j.jcv.2014.12.005 |url=}}</ref>
| |
| | align="left" style="background:#F5F5F5;" |
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| * History of prior infection
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| | align="center" style="background:#F5F5F5;" |+
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| | align="center" style="background:#F5F5F5;" |+
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| | align="center" style="background:#F5F5F5;" |+
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| | align="center" style="background:#F5F5F5;" |+
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| | align="center" style="background:#F5F5F5;" |+
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| | align="center" style="background:#F5F5F5;" |+
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| | align="center" style="background:#F5F5F5;" | ↓
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| | align="center" style="background:#F5F5F5;" | ↑
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Medication|Medications]]-Induced [[Thrombocytopenia|thrombocy]]<span name="harr_c115s002s001s003p001"></span><span name="9100757"></span>[[Thrombocytopenia|topenia]] <ref name="pmid25134884">{{cite journal |vauthors=Kam T, Alexander M |title=Drug-induced immune thrombocytopenia |journal=J Pharm Pract |volume=27 |issue=5 |pages=430–9 |date=October 2014 |pmid=25134884 |doi=10.1177/0897190014546099 |url=}}</ref><ref name="pmid23461497">{{cite journal |vauthors=Seco-Melantuche R, Delgado-Sánchez O, Álvarez-Arroyo L |title=[Incidence of drug-induced thrombocytopenia in hospitalized patients] |language=Spanish; Castilian |journal=Farm Hosp |volume=37 |issue=1 |pages=27–34 |date=2013 |pmid=23461497 |doi=10.7399/FH.2013.37.1.42 |url=}}</ref>
| | |[[Caprini score calculator]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:CapCal]] |
| *History of [[Medication|medications]] such as:
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| ** [[Furosemide]]
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| ** [[Non-steroidal anti-inflammatory drug|Nonsteroidal anti-inflammatory drugs]] ([[Non-steroidal anti-inflammatory drug|NSAIDs]])
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| ** [[Penicillin]]
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| ** [[Quinidine]]
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| ** [[Quinine]]
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| ** [[Ranitidine]]
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| ** [[Sulfonamide (medicine)|Sulfonamides]]
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| ** [[Linezolid]]
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" |+
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | ↓
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| | align="center" style="background:#F5F5F5;" | ↑
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Most important part of treatment is discontinuing of the medication.
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Heparin-Induced Thrombocytopenia|Heparin-Induced thrombocytopenia]]<span name="harr_c115s002s001s004p001"></span><span name="9100761"></span><ref name="pmid25629757">{{cite journal |vauthors=Warkentin TE, Safyan EL, Linkins LA |title=Heparin-induced thrombocytopenia presenting as bilateral adrenal hemorrhages |journal=N. Engl. J. Med. |volume=372 |issue=5 |pages=492–4 |date=January 2015 |pmid=25629757 |doi=10.1056/NEJMc1414161 |url=}}</ref>
| | |[[Wells score calculator for DVT]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:DVT Wells score calculator]] |
| * [[Thrombosis]]
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| * Unexplained [[thrombocytopenia]] up to 3 weeks after the end of [[heparin]] therapy
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
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| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | ↑
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| | align="center" style="background:#F5F5F5;" | For more information click here: [[Heparin-induced thrombocytopenia]].
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Idiopathic thrombocytopenic purpura|Immune Thrombocytopenic Purpura]] ([[Idiopathic thrombocytopenic purpura|ITP]])<span name="harr_c115s002s001s005p001"></span><span name="9100771"></span><ref name="pmid8857953">{{cite journal |vauthors=Wright JF, Blanchette VS, Wang H, Arya N, Petric M, Semple JW, Chia WK, Freedman J |title=Characterization of platelet-reactive antibodies in children with varicella-associated acute immune thrombocytopenic purpura (ITP) |journal=Br. J. Haematol. |volume=95 |issue=1 |pages=145–52 |date=October 1996 |pmid=8857953 |doi= |url=}}</ref>
| | |[[Modified Wells score calculator for DVT]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:DVT Modified Wells score calculator]] |
| * History of prior [[infection]] or no history
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | ↓
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| | align="center" style="background:#F5F5F5;" | ↑
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Inherited [[Thrombocytopenia]]<span name="harr_c115s002s001s006p001"></span><span name="9100783"></span><ref name="pmid27025194">{{cite journal |vauthors=Johnson B, Fletcher SJ, Morgan NV |title=Inherited thrombocytopenia: novel insights into megakaryocyte maturation, proplatelet formation and platelet lifespan |journal=Platelets |volume=27 |issue=6 |pages=519–25 |date=September 2016 |pmid=27025194 |pmc=5000870 |doi=10.3109/09537104.2016.1148806 |url=}}</ref><ref name="pmid30103613">{{cite journal |vauthors=Wang Q, Cao L, Sheng G, Shen H, Ling J, Xie J, Ma Z, Yin J, Wang Z, Yu Z, Chen S, Zhao Y, Ruan C, Xia L, Jiang M |title=Application of High-Throughput Sequencing in the Diagnosis of Inherited Thrombocytopenia |journal=Clin. Appl. Thromb. Hemost. |volume= |issue= |pages=1076029618790696 |date=August 2018 |pmid=30103613 |doi=10.1177/1076029618790696 |url=}}</ref>
| | |[[Pulmonary embolism Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" | | | |[[widget:PE_calculator]] |
| * Positive family history
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | ↓
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| | align="center" style="background:#F5F5F5;" | ↑
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Thrombotic thrombocytopenic purpura|Thrombotic Thrombocytopenic Purpura]] ([[Thrombotic thrombocytopenic purpura|TTP]])<span name="harr_c115s002s002s001p001"></span><span name="9100787"></span><ref name="pmid30220931">{{cite journal |vauthors=Knöbl P |title=Thrombotic thrombocytopenic purpura |journal=Memo |volume=11 |issue=3 |pages=220–226 |date=2018 |pmid=30220931 |doi=10.1007/s12254-018-0429-6 |url=}}</ref><ref name="pmid26386489">{{cite journal |vauthors=Mannucci PM, Cugno M |title=The complex differential diagnosis between thrombotic thrombocytopenic purpura and the atypical hemolytic uremic syndrome: Laboratory weapons and their impact on treatment choice and monitoring |journal=Thromb. Res. |volume=136 |issue=5 |pages=851–4 |date=November 2015 |pmid=26386489 |doi=10.1016/j.thromres.2015.09.007 |url=}}</ref>
| | |[[Pulmonary embolism modified Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" | History of: | | |[[Widget:PE Modified Wells score calculator]] |
| *[[Cancer]]
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| *[[Bone marrow transplantation]]
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| *[[Pregnancy]]
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| *[[Medication]]
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| **[[Platelet]] aggregation inhibitors ([[ticlopidine]] and [[clopidogrel]])
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| **Immunosuppressants ([[cyclosporine]], [[mitomycin]], [[tacrolimus]]/FK506, [[interferon|interferon-α]])
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| *[[HIV-1]] infection
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | ↓
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| | align="center" style="background:#F5F5F5;" | ↑
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| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Hemolytic-uremic syndrome|Hemolytic Uremic Syndrome]]<span name="harr_c115s002s002s002p001"></span><span name="9100796"></span><ref name="pmid24365375">{{cite journal |vauthors=Webster K, Schnitzler E |title=Hemolytic uremic syndrome |journal=Handb Clin Neurol |volume=120 |issue= |pages=1113–23 |date=2014 |pmid=24365375 |doi=10.1016/B978-0-7020-4087-0.00075-9 |url=}}</ref><ref name="pmid25845294">{{cite journal |vauthors=Picard C, Burtey S, Bornet C, Curti C, Montana M, Vanelle P |title=Pathophysiology and treatment of typical and atypical hemolytic uremic syndrome |journal=Pathol. Biol. |volume=63 |issue=3 |pages=136–43 |date=June 2015 |pmid=25845294 |doi=10.1016/j.patbio.2015.03.001 |url=}}</ref>
| | |[[AMUSE score calculator]] |
| | align="left" style="background:#F5F5F5;" |History of: | | |[[Widget:AMUSE_score_calculator]] |
| * [[Infections]]
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| * [[Malignancy]], [[chemotherapy]], and [[ionizing radiation]]
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| * [[Calcineurin inhibitor]]s and [[transplantation]]
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| * [[Pregnancy]], [[HELLP syndrome]], and [[oral contraceptive pill]]
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| * [[Systemic lupus erythematosis]]
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| * [[Antiphospholipid syndrome|Antiphospholipid antibody syndrome]]
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| * [[Glomerulopathy]]
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
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| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| |- | | |- |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |Thromobcytosis
| | |[[HAMILTON score calculator]] |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Iron deficiency anemia|Iron deficiency anemia]]
| | |[[Widget:HAMILTON_score_calculator]] |
| Inflammatory diseases
| | |- |
| | | |[[Geneva score calculator]] |
| [[Splenectomy]] | | |[[Widget:Geneva_score_calculator]] |
| | | |- |
| [[Essential thrombocytosis|Essential thrombocytosis]]
| | |[[Revised Geneva score calculator]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:Revised_Geneva_score_calculator]] |
| * Digital [[pain]]
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| * [[Gangrene]]
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| * [[Erythromelalgia]]
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| * H[[eadache]]
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| * [[Paresthesia|Paresthesias]]
| |
| * [[Transient ischemic attack|Transient ischemic attacks]]
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | +/-
| |
| | align="center" style="background:#F5F5F5;" | +/-
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| |- | | |- |
| ! rowspan="6" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Qualitative Disorders of [[Platelet]] Function<span name="harr_c115s002s004s001p001"></span><span name="9100803"></span>
| | |[[Simplified Geneva Score calculator]] |
| ! rowspan="4" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Inherited Disorders of [[Platelet]] Function<span name="harr_c115s002s004s001p001"></span><span name="9100803"></span>
| | |[[Widget:Simplified_Geneva_score_calculator]] |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Glanzmann's thrombasthenia|Glanzmann’s thrombasthenia]]
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Positive family history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | −
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| | align="center" style="background:#F5F5F5;" | Rare
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| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * AR inheritance
| |
| * Absence of the platelet Gp IIb/IIIa receptor
| |
| * Diminished for GP 2B-3A on [[Flow cytometry|flow cytometry]]
| |
| |- | | |- |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Bernard-Soulier syndrome]]<ref name="pmid30077511">{{cite journal |vauthors=Dupuis A, Gachet C |title=Inherited platelet disorders : Management of the bleeding risk |journal=Transfus Clin Biol |volume=25 |issue=3 |pages=228–235 |date=September 2018 |pmid=30077511 |doi=10.1016/j.tracli.2018.07.003 |url=}}</ref><ref name="pmid29227167">{{cite journal |vauthors=Andres O, Henning K, Strauß G, Pflug A, Manukjan G, Schulze H |title=Diagnosis of platelet function disorders: A standardized, rational, and modular flow cytometric approach |journal=Platelets |volume=29 |issue=4 |pages=347–356 |date=June 2018 |pmid=29227167 |doi=10.1080/09537104.2017.1386297 |url=}}</ref>
| | |[[TIMI Risk Score for Unstable Angina or NSTEMI]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:TIMI_UA_NSTEMI]] |
| * Positive family history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | Normal/↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * AR inheritance
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| * Absence of the platelet Gp Ib-IX-V receptor
| |
| * On PBS: giant platelets
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| * Ristocetin - no aggregation
| |
| |- | | |- |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Wiskott-Aldrich syndrome]]<ref name="pmid23527934">{{cite journal |vauthors=Wang YQ, Cui YX, Feng J |title=[Clinical phenotype and gene diagnostic analysis of Omenn syndrome] |language=Chinese |journal=Zhonghua Er Ke Za Zhi |volume=51 |issue=1 |pages=64–8 |date=January 2013 |pmid=23527934 |doi= |url=}}</ref><ref name="pmid27340577">{{cite journal |vauthors=Patil RB, Shanmukhaiah C, Jijina F, Bamborde S, Wasekar N, Toshniwal M, Mohite A, Patil V |title=Wiskott-Aldrich Syndrome Presenting with JMML-Like Blood Picture and Normal Sized Platelets |journal=Case Rep Hematol |volume=2016 |issue= |pages=8230786 |date=2016 |pmid=27340577 |pmc=4906177 |doi=10.1155/2016/8230786 |url=}}</ref><ref name="pmid29348920">{{cite journal |vauthors=Kaneko R, Yamamoto S, Okamoto N, Akiyama K, Matsuno R, Toyama D, Hoshino A, Imai K, Isoyama K |title=Wiskott-Aldrich syndrome that was initially diagnosed as immune thrombocytopenic purpura secondary to a cytomegalovirus infection |journal=SAGE Open Med Case Rep |volume=6 |issue= |pages=2050313X17753788 |date=2018 |pmid=29348920 |pmc=5768273 |doi=10.1177/2050313X17753788 |url=}}</ref><ref name="pmid19084106">{{cite journal |vauthors=Ozcan E, Notarangelo LD, Geha RS |title=Primary immune deficiencies with aberrant IgE production |journal=J. Allergy Clin. Immunol. |volume=122 |issue=6 |pages=1054–62; quiz 1063–4 |date=December 2008 |pmid=19084106 |doi=10.1016/j.jaci.2008.10.023 |url=}}</ref>
| | |[[TIMI Risk Score for STEMI]] |
| | align="left" style="background:#F5F5F5;" |
| | |[[Widget:TIMI_STEMI]] |
| * Positive family history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑ | |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Anti-WASP antibody can be used to detect presence or absence of WAS protein
| |
| * In Wiskott–Aldrich syndrome, the [[Platelet|platelets]] are small and do not function properly. They are removed by the [[spleen]], which leads to low [[platelet]] counts.
| |
| |- | | |- |
| ! align="left" style="padding: 5px 5px; background: #DCDCDC;" |[[Platelet storage pool deficiency|Platelet storage pool disorder (SPD)]]:
| | |[[Tygerberg score]] |
| *[[Hermansky-Pudlak syndrome]]
| | |[[widget:Tygerberg_score]] |
| *[[Chediak-Higashi syndrome]]
| |
| *[[Gray platelet syndrome]]
| |
| | align="center" style="background:#F5F5F5;" |
| |
| * Positive family history
| |
| * [[Hairy cell leukemia]]
| |
| * [[Cardiovascular bypass]]
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * AD inheritance
| |
| * Abnormalities of platelet granule formation
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Acquired Disorders of [[Platelet]] Function<span name="harr_c115s002s004s002p001"></span><span name="9100808"></span>
| | |[[CHA2DS2-VASc Score]] |
| | align="left" style="background:#F5F5F5 | | | |[[Widget:CHA2DS2VASc]] |
| * [[Chronic renal failure pathophysiology|Uremia]]
| |
| * [[Cardiopulmonary bypass]]
| |
| * Hematologic disorders such as: [[Myeloproliferative disease|myeloproliferative]] and [[Myelodysplastic syndrome|myelodysplastic syndromes]]
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | +/-
| |
| | align="center" style="background:#F5F5F5;" | +/-
| |
| | align="center" style="background:#F5F5F5;" | Normal/↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Von Willebrand disease|Von Willebrand Disease]]<span name="harr_c115s002s005p001"></span><span name="9100810"></span> <ref name="pmid25196510">{{cite journal |vauthors=Elbatarny M, Mollah S, Grabell J, Bae S, Deforest M, Tuttle A, Hopman W, Clark DS, Mauer AC, Bowman M, Riddel J, Christopherson PA, Montgomery RR, Rand ML, Coller B, James PD |title=Normal range of bleeding scores for the ISTH-BAT: adult and pediatric data from the merging project |journal=Haemophilia |volume=20 |issue=6 |pages=831–5 |date=November 2014 |pmid=25196510 |pmc=4251588 |doi=10.1111/hae.12503 |url=}}</ref><ref name="pmid25196510">{{cite journal |vauthors=Elbatarny M, Mollah S, Grabell J, Bae S, Deforest M, Tuttle A, Hopman W, Clark DS, Mauer AC, Bowman M, Riddel J, Christopherson PA, Montgomery RR, Rand ML, Coller B, James PD |title=Normal range of bleeding scores for the ISTH-BAT: adult and pediatric data from the merging project |journal=Haemophilia |volume=20 |issue=6 |pages=831–5 |date=November 2014 |pmid=25196510 |pmc=4251588 |doi=10.1111/hae.12503 |url=}}</ref><ref name="pmid16985174">{{cite journal |vauthors=Goodeve A, Eikenboom J, Castaman G, Rodeghiero F, Federici AB, Batlle J, Meyer D, Mazurier C, Goudemand J, Schneppenheim R, Budde U, Ingerslev J, Habart D, Vorlova Z, Holmberg L, Lethagen S, Pasi J, Hill F, Hashemi Soteh M, Baronciani L, Hallden C, Guilliatt A, Lester W, Peake I |title=Phenotype and genotype of a cohort of families historically diagnosed with type 1 von Willebrand disease in the European study, Molecular and Clinical Markers for the Diagnosis and Management of Type 1 von Willebrand Disease (MCMDM-1VWD) |journal=Blood |volume=109 |issue=1 |pages=112–21 |date=January 2007 |pmid=16985174 |doi=10.1182/blood-2006-05-020784 |url=}}</ref><ref name="pmid9579642">{{cite journal |vauthors=Mammen EF, Comp PC, Gosselin R, Greenberg C, Hoots WK, Kessler CM, Larkin EC, Liles D, Nugent DJ |title=PFA-100 system: a new method for assessment of platelet dysfunction |journal=Semin. Thromb. Hemost. |volume=24 |issue=2 |pages=195–202 |date=1998 |pmid=9579642 |doi=10.1055/s-2007-995840 |url=}}</ref><ref name="pmid258585642">{{cite journal |vauthors=Bodó I, Eikenboom J, Montgomery R, Patzke J, Schneppenheim R, Di Paola J |title=Platelet-dependent von Willebrand factor activity. Nomenclature and methodology: communication from the SSC of the ISTH |journal=J. Thromb. Haemost. |volume=13 |issue=7 |pages=1345–50 |date=July 2015 |pmid=25858564 |pmc=5576173 |doi=10.1111/jth.12964 |url=}}</ref>
| | |[[CHADS2 score]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:CHADS2score]] |
| * Easy bruising
| |
| * [[Epistaxis]]
| |
| * Oral cavity bleeding
| |
| * Bleeding after dental extraction/surgery
| |
| * [[Menorrhagia]]
| |
| * [[Postpartum hemorrhage]]
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | +/-
| |
| | align="center" style="background:#F5F5F5;" | +/-
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | See the table below for the details about different types.
| |
| |- | | |- |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Vessel wall disorders
| | |[[HAS-BLED score]] |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Metabolism|Metabolic]] and [[Inflammation|Inflammatory]] Disorders
| | |[[Widget:HASBLEDscore]] |
| ! align="left" style="padding: 5px 5px; background: #DCDCDC;" |
| |
| * Acute febrile illnesses
| |
| * [[Cryoglobulinemia|Mixed cryoglobulinemia]]
| |
| * [[Monoclonal gammopathy|Monoclonal gammopathies]]
| |
| * Certain pathogens, such as the rickettsiae causing [[Rocky Mountain spotted fever]]
| |
| * [[Vitamin C]] deficiency
| |
| * [[Cushing's syndrome|Cushing’s syndrome]]
| |
| * Chronic [[glucocorticoid]] therapy
| |
| * [[Ageing|Aging]]
| |
| * [[Vasculitis]] such as Henoch-Schönlein,
| |
| |
| |
| * History of the underlying disease.
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+/-</nowiki>
| |
| | -
| |
| | -
| |
| |Normal
| |
| |↑/Normal
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |<nowiki>-</nowiki>
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Inherited Disorders of the [[Vessel wall|Vessel Wall]]
| | |[[The GRACE risk score]] |
| ! align="left" style="padding: 5px 5px; background: #DCDCDC;" |
| | |[[Widget:GRACEscore]] |
| * [[Marfan's syndrome|Marfan’s syndrome]]
| |
| * [[Ehlers-Danlos syndrome]]
| |
| * [[Pseudoxanthoma elasticum]]
| |
| * [[Hereditary hemorrhagic telangiectasia]] ([[Hereditary hemorrhagic telangiectasia|HHT]], or [[Osler-Weber-Rendu|Osler-Weber-Rendu disease]])
| |
| |
| |
| * Positive family history
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+/-</nowiki>
| |
| | -
| |
| | -
| |
| |Normal
| |
| |↑/Normal
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |<nowiki>-</nowiki>
| |
| |- | | |- |
| ! rowspan="12" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Coagulation factor disorders<ref name="pmid29027765">{{cite journal |vauthors=Karimi M, Peyvandi F, Naderi M, Shapiro A |title=Factor XIII deficiency diagnosis: Challenges and tools |journal=Int J Lab Hematol |volume=40 |issue=1 |pages=3–11 |date=February 2018 |pmid=29027765 |doi=10.1111/ijlh.12756 |url=}}</ref><ref name="pmid27590165">{{cite journal |vauthors=Peyvandi F, Garagiola I, Biguzzi E |title=Advances in the treatment of bleeding disorders |journal=J. Thromb. Haemost. |volume=14 |issue=11 |pages=2095–2106 |date=November 2016 |pmid=27590165 |doi=10.1111/jth.13491 |url=}}</ref><ref name="pmid28966616">{{cite journal |vauthors=Bender L, Weidmann H, Rose-John S, Renné T, Long AT |title=Factor XII-Driven Inflammatory Reactions with Implications for Anaphylaxis |journal=Front Immunol |volume=8 |issue= |pages=1115 |date=2017 |pmid=28966616 |pmc=5605561 |doi=10.3389/fimmu.2017.01115 |url=}}</ref><ref name="pmid28966616" /><ref name="pmid27380557">{{cite journal |vauthors=Schmaier AH |title=Antithrombotic potential of the contact activation pathway |journal=Curr. Opin. Hematol. |volume=23 |issue=5 |pages=445–52 |date=September 2016 |pmid=27380557 |pmc=5148823 |doi=10.1097/MOH.0000000000000271 |url=}}</ref><ref name="pmid26565070">{{cite journal |vauthors=Schmaier AH |title=The contact activation and kallikrein/kinin systems: pathophysiologic and physiologic activities |journal=J. Thromb. Haemost. |volume=14 |issue=1 |pages=28–39 |date=January 2016 |pmid=26565070 |doi=10.1111/jth.13194 |url=}}</ref><ref name="pmid20580091">{{cite journal |vauthors=Kaplan AP, Ghebrehiwet B |title=The plasma bradykinin-forming pathways and its interrelationships with complement |journal=Mol. Immunol. |volume=47 |issue=13 |pages=2161–9 |date=August 2010 |pmid=20580091 |doi=10.1016/j.molimm.2010.05.010 |url=}}</ref><ref name="pmid22185738">{{cite journal |vauthors=Zuraw BL, Christiansen SC |title=Pathophysiology of hereditary angioedema |journal=Am J Rhinol Allergy |volume=25 |issue=6 |pages=373–8 |date=2011 |pmid=22185738 |doi=10.2500/ajra.2011.25.3661 |url=}}</ref><ref name="pmid23629422">{{cite journal |vauthors=Quail MT |title=Prekallikrein deficiency |journal=J Pediatr Oncol Nurs |volume=30 |issue=4 |pages=198–204 |date=2013 |pmid=23629422 |doi=10.1177/1043454213487436 |url=}}</ref><ref name="pmid27894217">{{cite journal |vauthors=Dorgalaleh A, Alavi SE, Tabibian S, Soori S, Moradi E, Bamedi T, Asadi M, Jalalvand M, Shamsizadeh M |title=Diagnosis, clinical manifestations and management of rare bleeding disorders in Iran |journal=Hematology |volume=22 |issue=4 |pages=224–230 |date=May 2017 |pmid=27894217 |doi=10.1080/10245332.2016.1263007 |url=}}</ref><ref name="pmid29483100">{{cite journal |vauthors=Maas C, Renné T |title=Coagulation factor XII in thrombosis and inflammation |journal=Blood |volume=131 |issue=17 |pages=1903–1909 |date=April 2018 |pmid=29483100 |doi=10.1182/blood-2017-04-569111 |url=}}</ref>
| |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Fibrinogen]] deficiency<ref name="pmid29844251">{{cite journal |vauthors=Tiscia GL, Margaglione M |title=Human Fibrinogen: Molecular and Genetic Aspects of Congenital Disorders |journal=Int J Mol Sci |volume=19 |issue=6 |pages= |date=May 2018 |pmid=29844251 |pmc=6032319 |doi=10.3390/ijms19061597 |url=}}</ref>
| |
| ! style="padding: 5px 5px; background: #DCDCDC;" |Different types of the [[fibrinogen]] disorders:
| |
| * [[Fibrinogen#Congenital afibrinogenemia|Congenital afibrinogenemia]]
| |
| * [[Fibrinogen#Congenital hypofibrinogenemia|Congenital hypofibrinogenemia]]
| |
| * [[Fibrinogen#Fibrinogen storage disease|Fibrinogen storage disease]]
| |
| * [[Fibrinogen#Congenital dysfibrinogenemia|Congenital dysfibrinogenemia]]
| |
| * [[Fibrinogen#Hereditary fibrinogen A.CE.B1-Chain amyloidosis|Hereditary fibrinogen Aα-Chain amyloidosis]]
| |
| * [[Fibrinogen#Acquired dysfibrinogenemia|Acquired dysfibrinogenemia]]
| |
| * [[Fibrinogen#Congenital hypodysfibrinogenemia|Congenital hypodysfibrinogenemia]][[Fibrinogen#Cryofibrinogenemia|Cryofibrinogenemia]]
| |
| * [[Fibrinogen#Acquired hypofibrinogenemia|Acquired hypofibrinogenemia]]
| |
| | | | | |
| * [[Epistaxis]]
| |
| * Easy [[Bruise|bruising]]
| |
| * [[Menorrhagia]]
| |
| * [[Muscle]] bleeds
| |
| * [[Hemarthrosis]]
| |
| * [[Bleeding]] from the [[umbilical cord]] stump after birth
| |
| * Bleeding after [[dental surgery]] or tooth extraction
| |
| * Abnormal bleeding during or after injury, surgery, or childbirth
| |
|
| |
| * [[Gastrointestinal tract|Gastrointestinal]] [[hemorrhage]]
| |
| * [[Cerebral hemorrhage]]
| |
| * [[Thrombosis]]
| |
| |<nowiki>-</nowiki>
| |
| | -
| |
| | +
| |
| | +
| |
| | +/-
| |
| | +
| |
| |Normal
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↑
| |
| | | | | |
| * Impaired fibrin cross linking or clot dissolution.
| |
|
| |
| * The severity of bleeding in patients with fibrinogen disorders can be mild or severe, with higher bleeding risk in those with afibrinogenemia or lower levels of functional fibrinogen. The age of onset is also variable, with earlier onset in those with more severe deficiency.
| |
| |- | | |- |
| ! colspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Prothrombin deficiency]]
| | |[[Ranson criteria]] |
| | | | [[Acute pancreatitis diagnostic criteria]] |
| * Easy [[bruising]]
| | |[[Widget:RansonScore]] |
| * [[Epistaxis]]
| | |- |
| * Soft-tissue hemorrhage
| | |[[Apgar score]] |
| * Excessive postoperative bleeding
| | |[[Widget:Apgarscore]] |
| * [[Menorrhagia]]
| | |- |
| * Muscle [[Hematoma|hematomas]]
| | |[[Glasgow coma scale]] |
| * [[Hemarthrosis]]
| | |[[Widget:Adult_GCS]] |
| * [[Intracranial hemorrhage|Intracranial]] bleeding
| | |- |
| | | | |[[Pediatric Glasgow Coma Scale]] |
| |<nowiki>+</nowiki> | | |[[Widget:PGCS]] |
| |<nowiki>+</nowiki> | | |- |
| |<nowiki>+</nowiki> | | |[[Cincinnati stroke scale]] |
| |<nowiki>+</nowiki> | | |[[Widget:Cincinnati_Stroke_Scale]] |
| |<nowiki>+</nowiki> | | |- |
| |Normal | | |[[DIPSS Plus Score]] |
| |Normal | | |[[Widget:DIPSS_Plus_Score]] |
| |↑ | | |- |
| |↑ | | | colspan="2" |[[ICU scoring systems]] |
| |↑ | | |- |
| |<nowiki>-</nowiki> | | |[[APACHE II]] |
| | |[[Widget:APACHEII]] |
| | |- |
| | |[[SAPS II]] |
| | |[[Widget:SAPSII]] |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor V deficiency]]
| | |[[SAPS III]] |
| | | | |[[Widget:SAPSIII]] |
| * Excessive bruising with minor injuries
| |
| * [[Epistaxis]]
| |
| * [[Hemarthrosis]]
| |
| * [[Menorrhagia]]
| |
| * [[Intracerebral hemorrhage|Intracerebral hemorrhages]]
| |
| * [[Pulmonary hemorrhage]]
| |
| |
| |
| |_
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| | +
| |
| |Normal
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |Normal
| |
| |The severity of bleeding is only partly related to the degree of factor V deficiency. Some patients with undetectable plasma levels of factor V experience only relatively mild bleeding.
| |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor VII deficiency]]
| | |[[PIM2]] |
| | | | | |
| * Easy [[Bruise|bruising]]
| | |} |
| * Mucosal bleeding
| | ==Table== |
| * Postoperative bleeding
| | {| |
| * [[Menorrhagia]]
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Complications |
| * Soft tissue hematomas
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Polymyositis |
| * [[Thrombosis]]
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dermatomyositis |
| | | |
| | | |
| |
| |
| |<nowiki>+</nowiki>
| |
| | + | |
| | +
| |
| |Normal
| |
| |
| |
| |↑
| |
| |Normal
| |
| |Normal
| |
| |Thrombosis occurs in inherited factor VII deficiency most cases are associated with the administration of factor VII replacement therapy | |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor X deficiency]] | | ! align="center" style="background:#DCDCDC;" + |[[Cancer|Malignancy]] |
| | | | | align="left" style="background:#F5F5F5;" + | |
| * Prolonged bleeding following circumcision
| | *[[Lung]] |
| | | align="left" style="background:#F5F5F5;" + | |
| | *[[Lung]] |
| | |} |
| | <br> |
| | ===Calculation of the Padua Prediction Score=== |
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
|
| |
|
| * Easy [[Bruise|bruising]]
| | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| * [[Hematuria]]
| | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| * [[Menorrhagia]]
| | |- |
| * Abortion
| | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| * Postpartum hemorrhage
| | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| * Epistaxis
| | |- |
| * Pseudotumors
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active gastric or duodenal ulcer |
| * Intracranial bleeding
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4.5 |
| * Hemarthroses
| | |- |
| | | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Prior bleeding within the last 3 months |
| |<nowiki>+</nowiki> | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| | + | | |- |
| | + | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Thrombocytopenia (<50x10<sup>9</sup>/L) |
| | + | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| | + | | |- |
| |Normal | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age ≥ 85 years |
| |Normal | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |3.5 |
| |↑ | | |- |
| |↑ | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Liver failure (INR>1.5) |
| |Normal | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| |<nowiki>-</nowiki> | | |- |
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Severe kidney failure (GFR< 30 mL/min/m<sup>2</sup>) |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor XII|Factor XII deficiency]] | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Admission to ICU or CCU |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| * Majority,asymptomatic
| |
| * Recurrent miscarriages
| |
| * Painful leg ulcers
| |
| |
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| |
| |
| |- | | |- |
| ! colspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[High-molecular-weight kininogen|High molecular weight kininogen (HMWK)]] deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Central venous catheter |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| * Possibility of positive family history of bleeding
| |
| |
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| | | |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Prekallikrein]] deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Rheumatic disease |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| * Possibility of positive family history of bleeding
| |
| |
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| |
| |
| |- | | |- |
| ! colspan="2" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor XIII deficiency]] | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active malignancy |
| ! style="padding: 5px 5px; background: #DCDCDC;" |Types:
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| * Sub unit A mutation disease (more common)
| |
| * Sub unit B mutation disease
| |
| |
| |
| * Possibility of positive family history of bleeding
| |
| | -/+
| |
| | -/+
| |
| |<nowiki>-/+</nowiki>
| |
| |<nowiki>-/+</nowiki>
| |
| |<nowiki>-/+</nowiki> | |
| |<nowiki>-/+</nowiki>
| |
| |Normal
| |
| |Normal
| |
| |Normal/↑
| |
| |Normal
| |
| |Normal
| |
| |
| |
| * Impaired fibrin cross linking or clot dissolution
| |
| * The severity of factor XIII deficiency bleeds can be different in different patients
| |
| |- | | |- |
| ! rowspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Hemophilia]]<ref name="pmid94489952">{{cite journal |vauthors=Aviña-Zubieta JA, Galindo-Rodriguez G, Lavalle C |title=Rheumatic manifestations of hematologic disorders |journal=Curr Opin Rheumatol |volume=10 |issue=1 |pages=86–90 |date=January 1998 |pmid=9448995 |doi= |url=}}</ref><ref name="pmid16551972">{{cite journal |vauthors=Plug I, Mauser-Bunschoten EP, Bröcker-Vriends AH, van Amstel HK, van der Bom JG, van Diemen-Homan JE, Willemse J, Rosendaal FR |title=Bleeding in carriers of hemophilia |journal=Blood |volume=108 |issue=1 |pages=52–6 |date=July 2006 |pmid=16551972 |doi=10.1182/blood-2005-09-3879 |url=}}</ref><ref name="pmid25059285">{{cite journal |vauthors=Blanchette VS, Key NS, Ljung LR, Manco-Johnson MJ, van den Berg HM, Srivastava A |title=Definitions in hemophilia: communication from the SSC of the ISTH |journal=J. Thromb. Haemost. |volume=12 |issue=11 |pages=1935–9 |date=November 2014 |pmid=25059285 |doi=10.1111/jth.12672 |url=}}</ref><ref name="pmid11307831">{{cite journal |vauthors=White GC, Rosendaal F, Aledort LM, Lusher JM, Rothschild C, Ingerslev J |title=Definitions in hemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Thrombosis and Haemostasis |journal=Thromb. Haemost. |volume=85 |issue=3 |pages=560 |date=March 2001 |pmid=11307831 |doi= |url=}}</ref><ref name="pmid24026910">{{cite journal |vauthors=Favaloro EJ, Meijer P, Jennings I, Sioufi J, Bonar RA, Kitchen DP, Kershaw G, Lippi G |title=Problems and solutions in laboratory testing for hemophilia |journal=Semin. Thromb. Hemost. |volume=39 |issue=7 |pages=816–33 |date=October 2013 |pmid=24026910 |doi=10.1055/s-0033-1356573 |url=}}</ref><ref name="pmid250592852">{{cite journal |vauthors=Blanchette VS, Key NS, Ljung LR, Manco-Johnson MJ, van den Berg HM, Srivastava A |title=Definitions in hemophilia: communication from the SSC of the ISTH |journal=J. Thromb. Haemost. |volume=12 |issue=11 |pages=1935–9 |date=November 2014 |pmid=25059285 |doi=10.1111/jth.12672 |url=}}</ref> | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age: 40-84 years |
| | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1.5 |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Type A deficiency
| |
| |
| |
| * Eeasy [[Bruise|bruising]]
| |
| * Inadequate clotting in [[trauma]] or mild injury
| |
| * Spontaneous hemorrhage
| |
| * [[Hemarthrosis]]
| |
| * [[Epistaxis]]
| |
| * [[Gingival bleeding]]
| |
| | -
| |
| | -
| |
| | -
| |
| | + | |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| |<nowiki>-</nowiki>
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Type B deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| * Neonatal bleeding
| |
| * Trauma-related soft-tissue hemorrhage
| |
| * [[Hemarthrosis]]
| |
| * [[Hematoma|Hematomas]]
| |
| | -
| |
| | -
| |
| | -
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |Normal
| |
| |Normal
| |
| |Normal | |
| |↑
| |
| |Normal
| |
| |<nowiki>-</nowiki>
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Type C deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Moderate kidney failure (GFR: 30-59 mL/min/m<sup>2</sup>) |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| * Family history
| |
| * Bleeding after surgery or injury
| |
| | -
| |
| | -
| |
| | -
| |
| |<nowiki>+</nowiki>
| |
| |Rare | |
| |Rare
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| | - | |
| |- | | |- |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rare diseases | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Disseminated intravascular coagulation|Disseminated Intravascular Coagulation]]<ref name="pmid30008620">{{cite journal |vauthors=Wada H, Matsumoto T, Suzuki K, Imai H, Katayama N, Iba T, Matsumoto M |title=Differences and similarities between disseminated intravascular coagulation and thrombotic microangiopathy |journal=Thromb J |volume=16 |issue= |pages=14 |date=2018 |pmid=30008620 |pmc=6040080 |doi=10.1186/s12959-018-0168-2 |url=}}</ref>
| |
| ! style="padding: 5px 5px; background: #DCDCDC;" |
| |
| * [[Trauma]]
| |
| * Burn
| |
| * [[Crush injury]]
| |
| * [[Sepsis]]
| |
| * [[Malignancy]]
| |
| * Obstetric complication: abruption, amniotic fluid embolism
| |
| * [[Hemolytic anemia]]
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |↓
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |Normal
| |
| | -
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Vitamin K Deficiency]]<ref name="pmid26314836">{{cite journal |vauthors=Shiraishi E, Iijima H, Shinzaki S, Nakajima S, Inoue T, Hiyama S, Kawai S, Araki M, Yamaguchi T, Hayashi Y, Fujii H, Nishida T, Tsujii M, Takehara T |title=Vitamin K deficiency leads to exacerbation of murine dextran sulfate sodium-induced colitis |journal=J. Gastroenterol. |volume=51 |issue=4 |pages=346–56 |date=April 2016 |pmid=26314836 |doi=10.1007/s00535-015-1112-x |url=}}</ref> | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
| ! style="padding: 5px 5px; background: #DCDCDC;" |
| |
| * Bleeding after trauma
| |
| * [[Epistaxis]]
| |
| * [[Hematoma]]
| |
| * Gastrointestinal bleeding
| |
| * [[Menorrhagia]]
| |
| * [[Hematuria]]
| |
| * Gum bleeding
| |
| * Oozing from venipuncture sites
| |
| * Easy [[Bruise|bruisability]]
| |
| |<nowiki>+</nowiki>
| |
| | -
| |
| | +
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |Normal
| |
| |↑
| |
| |↑
| |
| |Normal or mildly prolonged
| |
| |Normal
| |
| | -
| |
| |} | | |} |
| Different types of Von-Willebrand diseases can be differentiated from each other based on the following table:<ref name="pmid258585643">{{cite journal |vauthors=Bodó I, Eikenboom J, Montgomery R, Patzke J, Schneppenheim R, Di Paola J |title=Platelet-dependent von Willebrand factor activity. Nomenclature and methodology: communication from the SSC of the ISTH |journal=J. Thromb. Haemost. |volume=13 |issue=7 |pages=1345–50 |date=July 2015 |pmid=25858564 |pmc=5576173 |doi=10.1111/jth.12964 |url=}}</ref>
| | <br style="clear:left" /> |
| | |
| | ===Calculation of the test Prediction Score=== |
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
|
| |
|
| {| | | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type of VWD
| | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type of factor deficiency
| | |- |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Prevalence
| | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inheritance pattern | | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
| | |- |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |VWF activity | | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Gender |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RIPA | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Female |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Factor VIII | | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| | |- |
| | ! rowspan="4" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |0-70 |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |71-80 |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |81-90 |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>90 |
| | |- |
| | ! rowspan="5" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Hgb ('''g/dL)''' |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>17 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15.5-17 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-15.5 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-11 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<11 '''g/dL''' |
| | |- |
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |CrCl (mL/min) |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |30-60 mL/min |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15-30 mL/min |
| | |- |
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Albumin |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>3.5 g/dL |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≤3.5 g/dL |
| | |- |
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |D-dimer |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≥1 µg/mL |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" |Type 1
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<1 µg/mL |
| | align="center" style="background:#F5F5F5;" | Quantitative/ partial
| |
| | align="center" style="background:#F5F5F5;" | 60-70%
| |
| | align="center" style="background:#F5F5F5;" | AD
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Bleeding severity mild to severe
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| |- | | |- |
| ! rowspan="4" align="center" style="background:#DCDCDC;" |Type 2 | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |ICU admission |
| ! align="center" style="background:#DCDCDC;" |2A<ref name="pmid1537829">{{cite journal |vauthors=Lyons SE, Bruck ME, Bowie EJ, Ginsburg D |title=Impaired intracellular transport produced by a subset of type IIA von Willebrand disease mutations |journal=J. Biol. Chem. |volume=267 |issue=7 |pages=4424–30 |date=March 1992 |pmid=1537829 |doi= |url=}}</ref>
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | align="center" style="background:#F5F5F5;" | Qualitative | |
| | align="center" style="background:#F5F5F5;" | 10%
| |
| | align="center" style="background:#F5F5F5;" | AD/AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Moderate to severe [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | N or ↓
| |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" |2B | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Acute stroke on hospitalization |
| | align="center" style="background:#F5F5F5;" | Qualitative
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | align="center" style="background:#F5F5F5;" | 5%
| |
| | align="center" style="background:#F5F5F5;" | AD
| |
| | align="left" style="background:#F5F5F5;" | | |
| * [[Thrombocytopenia]]
| |
| * Moderate to severe [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | N or ↓
| |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" |2M | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |History of VTE |
| | align="center" style="background:#F5F5F5;" | Qualitative
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | align="center" style="background:#F5F5F5;" | <1% | |
| | align="center" style="background:#F5F5F5;" | AD/AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Moderate to severe [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | N or ↓
| |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" |2N | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
| | align="center" style="background:#F5F5F5;" | Qualitative
| |
| | align="center" style="background:#F5F5F5;" | <1%
| |
| | align="center" style="background:#F5F5F5;" | AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Clinically similar to [[hemophilia A]] with [[joint]], [[soft tissue]], [[urinary]] [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | N
| |
| | align="center" style="background:#F5F5F5;" | N
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" |Type 3 | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
| | align="center" style="background:#F5F5F5;" | Complete deficiency
| |
| | align="center" style="background:#F5F5F5;" | 1-2%
| |
| | align="center" style="background:#F5F5F5;" | AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Clinically similar to [[hemophilia A]] with [[joint]] and [[soft tissue]] [[bleeding]]
| |
| * Severe [[mucosal bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | Absent
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | Low, 1-10%
| |
| |} | | |} |
| For more information on Von Willebrand disease, click [[ von willebrand disease | here]].
| | <br style="clear:left" /> |
| | |
| | ===Interpretation of the Padua Prediction Score=== |
| | The interpretation of the score is as follows: |
| | * Score ≥ 4: High risk for VTE |
| | * Score < 4: Low risk for VTE |
| | ==References== |
| | <references /> |