What are ‘bleeding disorders’?
Bleeding disorders are due to:
Platelet disorders (quantitative diminution and/or qualitative defects in platelets):
There is H/o gum bleeding, epistaxis or bleeding from vagina along with
presence of petechiae, purpura or ecchymosis. Bleeding occurs spontaneously or
immediately after trauma and local pressure can stop bleeding. Bleeding time (BT)
is prolonged but coagulation time (CT) remains normal, while platelet count may
be diminished (in quantitative diminution).
Coagulation disorders e.g., haemophilia or Christmas disease. Only affects males
while females are the carriers. These are X-linked diseases with oblique transmission
(uncle and nephew may be the sufferers). Bleeding occurs in viscera, muscles,
retroperitoneum and joints; bleeding from nose, mouth, urinary tract may occur.
Bleeding starts hours after trauma but notorious for persistence; local pressure can
not stop bleeding. BT is normal while CT is prolonged with normal platelet count.
Factor VIII or IX assay can confirm the diagnosis.
Vessel wall abnormalities: Commonly seen in old age. This abnormality is common
in HSP, infections (e.g., meningococcus), senile purpura, Cushing’s syndrome or
prolonged corticosteroid therapy, uraemia and vasculitis. Petechiae, purpura, and
bleeding immediately after trauma is common; local pressure can stop bleeding.
The BT is prolonged with normal CT and normal platelet count.
Conditions like septicaemia or uraemia affect all the three abnormalities described
above.
Bleeding disorders are due to:
Platelet disorders (quantitative diminution and/or qualitative defects in platelets):
There is H/o gum bleeding, epistaxis or bleeding from vagina along with
presence of petechiae, purpura or ecchymosis. Bleeding occurs spontaneously or
immediately after trauma and local pressure can stop bleeding. Bleeding time (BT)
is prolonged but coagulation time (CT) remains normal, while platelet count may
be diminished (in quantitative diminution).
Coagulation disorders e.g., haemophilia or Christmas disease. Only affects males
while females are the carriers. These are X-linked diseases with oblique transmission
(uncle and nephew may be the sufferers). Bleeding occurs in viscera, muscles,
retroperitoneum and joints; bleeding from nose, mouth, urinary tract may occur.
Bleeding starts hours after trauma but notorious for persistence; local pressure can
not stop bleeding. BT is normal while CT is prolonged with normal platelet count.
Factor VIII or IX assay can confirm the diagnosis.
Vessel wall abnormalities: Commonly seen in old age. This abnormality is common
in HSP, infections (e.g., meningococcus), senile purpura, Cushing’s syndrome or
prolonged corticosteroid therapy, uraemia and vasculitis. Petechiae, purpura, and
bleeding immediately after trauma is common; local pressure can stop bleeding.
The BT is prolonged with normal CT and normal platelet count.
Conditions like septicaemia or uraemia affect all the three abnormalities described
above.