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Bleeding Disorder







Coagulopathy

  • Blood coagulation or clotting is a much needed body mechanism that protects against excessive bleeding following an injury or trauma.  Coagulation is a complex process involving many blood-clotting factors (proteins) operating in a cascade that, if interfered with, may lead to serious and dangerous bleeding disorders.
  • Bleeding problems can range from mild to severe.  Coagulation factors, platelets, and other substances work together to stop bleeding at the site of an injury.  This is accomplished by the formation of fibrin, the material that clots are made of.
  • Defects in the coagulation system occur as a result of deficiencies in clotting factors, missing clotting factors, or changes in platelet function.  These disorders can be inherited, may be due to an underlying disease, or may be side effects of drugs or medication.
  • Defects in platelets usually are noticed with the onset of bleeding after an injury.  Such defects are predominantly superficial, i.e., in skin, mucous membranes such as found in the nose, the lining of gastrointestinal tract, and urinary tract.
  • Bleeding may be observed as petechiae (<3 ecchymoses="" mm="" or="">3 mm).
  • Coagulation system defects lead to deeper bleeding than platelet defects.  There may be bleeding into joints (hemarthroses), muscle (hematomas), and abdomen.
  • Nose bleeds, bleeding gums, Bruising, and heavy or prolonged menstrual periods may all be signs of bleeding problems.

  • Deficiencies in factor II, V, VII, XII
  • Myelofibrosis
  • Vitamin K Deficiency
  • Hemophilia A and B and Von Willebrand's Disease
  • ITP
  • TTP
  • Congenital Antithrombin III; protein c and    protein s deficiency
  • Disseminated intravascular coagulopathy
  • Drugs -- cephalosporins, penicillins, dipyridamole, alcohol, sulfonamides, Rifampin, methyldopa, Phenytoin, warfarin, heparin, urokinase, TPA, NSAIDs (e.g., aspirin), diuretics, allopurinol, etc.

  • See underlying cause
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