Bleeding disorder refer to the problem of the body usually clotting blood. Coagulation (also called clotting) transforms blood from a liquid into a solid. The blood may not clot correctly in some circumstances, resulting in severe or long-lasting bleeding.
Several bleeding problems can result in abnormal bleeding, both external and internal. Certain conditions can cause drastic increases in bleeding under the skin in specific sensitive organs, such as the brain.
Types of bleeding disorders
A bleeding disorder can either be inherited or acquired. An inherited condition passes down genetically from one generation to another. Alternatively, acquired disorders may develop or spontaneously happen later in life. Bleeding may become severe during an accident or injury due to some bleeding disorders. While severe bleeding can occur instantly and without any apparent reason in some diseases. There are various types of bleeding disorders, but the following are some of the utmost usual ones:
- Hemophilia: Normally, your blood has high clotting factors (II, V, VII, X, or XII); however, if you do not have sufficient clotting factors, you will suffer from hemophilia A or B. These conditions cause severe or abnormal bleeding into the joints. Though hemophilia is very uncommon, but it can be fatal in some cases.
- Von Willebrand’s disease: The utmost usual inherited bleeding disorder is ‘Von Willebrand’s disease. The situation happens when the blood is deficient in the von Willebrand factor, necessary to clot blood normally.
- Liver disease: Several conditions can lead to liver failure, including the inability to produce coagulation factors. If patients do not have these factors (II, V, VII, X, or XII), they may experience significant bleeding.
- Low platelet count: In the case of thrombocytopenia (low platelet count), several factors may be responsible for this situation, including leukemia, chemotherapy side effects, and immune thrombocytopenia (in which the immune system destroys the platelets).
- Platelet function disorder: Blood problems can occur due to low platelet counts an d platelet function problems. However, a combination may cause severe bleeding.
Following factors (II, V, VII, X, or XII) can play a significant role in bleeding disorder;
Causes of bleeding disorder
If someone bleeds, the body usually pools blood cells together to stop the bleeding by forming a clot. A clotting factor is a protein found in the blood that works with platelets to form clots. Hemophilia occurs when there are insufficient clotting factors in the body or when the levels of the clotting factors are low.
- Congenital hemophilia: In most cases, hemophilia inherits, meaning that the person is born with the congenital disorder. A person who has congenital hemophilia will have low levels of the clotting factors in the body. Hemophilia A is the most usual kind, and it is related to a low level of factor 8. Hemophilia B is the second most usual kind, relevant to the low level of factor 9.
- Acquired hemophilia: Individuals without a family history of hemophilia can also develop the disorder. This condition is called acquired hemophilia, in which the immune system attacks the clotting factor 8 or 9 in the blood. The following factors can be responsible for acquired hemophilia;
- Pregnancy
- Autoimmune diseases
- Cancer
- Multiple sclerosis
- Drugs reaction
- Inherited hemophilia: Generally, the faulty gene in hemophilia is present on the X chromosome. Every individual has two sex chromosomes, one from each parent. In females, an X chromosome is inherited from the mother, and another X chromosome is inherited from the father. While the male takes an X chromosome from the mother and a Y chromosome from the father. In other words, hemophilia usually affects boys that go down from mother to son through a gene from one of the mother’s cells. A high percentage of women with the faulty gene are carriers of hemophilia.
Symptoms
- Menstrual bleeding that is excessive during periods (periods) may include the following:
- An extended period of bleeding lasts more than seven days.
- Floating or gushing of blood interferes with daily activities such as work, school, exercise, and social activities.
- Blood clots are larger than a grape size.
- During heavy periods, soak a tampon or pad frequently every hour.
- A diagnosis of iron deficiency or having received treatment for anemia.
- Easy or frequent bleeding can cause these symptoms:
- An unexplained nosebleed lasts more than ten minutes or requires medical attention.
- Bruising occurs without physical injury.
- Abnormal bleeding following a medical procedure or dental extraction.
- History of muscle or joint bleeding without any physical injury.
Diagnosis
The symptoms and medical history of a patient will assist the doctor in diagnosing a bleeding disorder. During your appointment, the doctor will do a physical test and ask about the following details:
- Any current medical conditions you may have.
- Medications you are currently taking.
- Recent falls or injuries.
- When the bleeding occurs.
- How long does bleeding last.
- Your activities before the bleeding began.
After gathering this information, your physician will run blood tests to make a correct diagnosis. Blood tests may include:
- CBC: Complete Blood Count (CBC) measures red and white blood cells in your body.
- Platelet aggregation test: This test determines how well your platelets clump together.
- Bleeding time test: The bleeding time test measures how fastly your blood clots prevent bleeding.
Complications of bleeding disorder
- Internal bleeding: The limbs can swell in case of bleeding in the deep muscle. The inflammation can press on nerves and cause senselessness or discomfort. In some cases, bleeding can be fatal.
- Intense bleeding into the neck or throat: Such bleeding may affect a person’s breathing ability.
- Damage to joints: Internal bleeding may cause severe pain in the joints. If not treated on time, continuous inner bleeding may lead to arthritis or joint destruction.
- Infection: In the case of hemophilia, clotting factors derived from human blood may be more vulnerable to virus infections such as hepatitis C. However, donor screening techniques minimize this risk.
Treatment of bleeding disorder
A person with a bleeding disorder may undergo a variety of treatment options depending on the cause of the bleeding disorder and the area in which the bleeding occurs. Treatment options may include;
- Factor replacement: Hemophilia sufferers can inject themselves with factor-replacing substances that regularly cure bleeding episodes.
- Desmopressin: Desmopressin (brand name is Stimate) is a replacing product for the hormone vasopressin that is mostly used in the clinical setting. It stimulates a temporary boost up the level of von Willebrand antigen and factor 8, which may prevent bleeding in patients with mild hemophilia A or von Willebrand disease.
- Transfusion of platelets: In case of low platelet count or the improper functioning of platelets, a platelet transfusion might be used to stop or treat bleeding.
- Fresh frozen plasma: Plasma is the liquid component of blood and contains several coagulation factors. In severe cases such as liver failure, fresh frozen plasma may be given as an infusion to treat the bleeding disorder.
- Vitamin K: If a patient is deficient in Vitamin K, they may require supplementation.
- Antifibrinolytics: Antifibrinolytics prevent excessive bleeding through the stabilization of blood clots. The principal use of these medications is to control bleeding from the mouth or heavy menstruation.
References:
- https://www.healthline.com/health/bleeding-disorders#types retrieved on April 24, 2022.
- https://www.mayoclinic.org/diseases-conditions/hemophilia/symptoms-causes/syc-20373327 retrieved on April 24, 2022.
- https://www.cdc.gov/ncbddd/blooddisorders/women/symptoms.html retrieved on April 24, 2022.
- https://www.veryw
