The blood carries nutrients and minerals throughout the body via blood vessels. Blood vessels may sustain damage in the course of day-to-day activities and may result in a leakage of blood from the vessels. In light of this, the blood is able to coagulate and form a clot with the help of VitK and platelet, at the area of damage so as to block the leak formed. However, under certain circumstances, the blood may fail to coagulate(clot) effectively (called hypocoagulability). This may lead to an abnormal tendency to bleed, called bleeding diathesis where “Diathesis’’ is defined as a predisposition of the body towards a disease or a group of diseases. It is to be noted that bleeding diathesis can be due to various reasons given that, it is mostly a symptom of a disease and not the disease itself. Severity might range from mild to life threatening.
There are various causes that contribute towards bleeding diathesis but excessive bleeding and inability to clot hold true amongst all of them. The causes can be generally bifurcated into three categories:
- Acquired: a few examples include low platelet count, use of anticoagulants like warfarin, heparin, deficiency in vitamin D, scurvy, vitamin K deficiency, kidney failure, DIC( Dissemination Intravascular Coagulation), acquired clotting factor deficiency, viral hemorrhagic fever, liver failure, and also due to the venom of poisonous snakes that are known to affect the coagulation properties of blood.
- Genetic Causes: Some individuals may not be able to produce the proteins in charge of coagulation. Genetic disorders like Von Willebrand disease and various types of haemophilia have been associated with bleeding diathesis. Also, a parent who has some sort of bleeding diathesis runs the risk of passing it on to his/her child. This is because most of these diseases are gender-linked, X chromosome diseases.
- Autoimmune Causes: There is also a chance that the immune system may for whatever reason try to inhibit coagulation in the body (1).
A common symptom of bleeding diathesis is the formation of purpura. They are purple coloured spots that are recognizable through the skin due to the bursting of capillaries present under the skin. Though mostly associated with low platelet counts, it may be due to a host of other reasons like cancer, chemotherapy, HIV, etc. Purpura may be tiny (pin sized) , called Petichea( small, flat, rash-like dots which appear beneath the skin). It usually indicates platelet deficiency or defect in the blood vessel wall or maybe large spots called Ecchymoses. It is associated with a disorder in the clotting mechanism (2). Other symptoms include bleeding from the nose, blood in stools and urine, excessive bleeding from minor cuts and injuries and an excessive bleeding from menstruation, heavy bleeding after the surgery, hematemesis (vomit blood), etc
Diagnosis and Treatment
If you are showcasing any of the above symptoms, it is wise that you visit a doctor immediately and get yourself checked. A few of the tests that your doctor may recommend you to perform so as to diagnose the cause of the bleeding are:
- Platelet count
- Full Body count
- Blood film
- Vitamin K profile
- Liver function test
- Bone marrow biopsy
- Gene Analysis
- Bleeding time (BT)
- Thrombin clotting time (CT)and
- Activated partial thromboplastin time(aPTT)
- Genetic testing (helps in identifying the defective genes causing bleeding disorders).
Treatment of bleeding diastasis depends on the cause and severity of the disease. However, trying to stop the bleeding takes priority. This may be done by platelet transfusion, vitamin K supplementation in case of VitK deficiency, antifibrinolytics, and anticoagulant medicine. If the bleeding is due to an infection, antibiotic treatment may help (3). While genetically inherited diseases can be treated by gene therapy (wherein an abnormal defective gene is replaced by a normal one).
- Salina. Causes Of Bleeding Diathesis: Symptoms, Diagnosis And Treatment. Simple-Remedies.com. [Online] [Cited: April 27, 2017.] http://www.simple-remedies.com/home-remedies/autoimmune-diseases/bleeding-diathesis-causes.html.
- Amber Erickson Gabbey, Erica Cirino. Purpura. Healthline.com. [Online] [Cited: April 27, 2017.] http://www.healthline.com/health/purpura#overview1.
- Tandurust. What Causes Bleeding Diathesis? Its Symptoms And Treatment Options. Tandurust.com. [Online] September 11, 2012. [Cited: April 27, 2017.] http://www.tandurust.com/health-answers/bleeding-diathesis-causes-symptoms.html.