Bleeding, that is difficult to stop, is the result of disorder of blood clotting. Heavy bleeding may start even after minor injuries, sometimes without the influence of external factors (spontaneous bleeding). Perhaps the appearance of the so-called purpura – single or multiple hemorrhages in the skin, and (or) the mucous membranes. However, internal bleeding (such as muscles, joints, organs, brain) is much more dangerous. A tendency for such bleeding depends on the severity of the disease, which causes bleeding.
For blood clotting platelets are very important. The main functions of platelets:
- Platelet clots blocks the blood vessel.
- Stimulating the generation of fibrin, this promotes the formation of a blood clot.
- Stimulating hormone secretion, which causes a reduction in blood vessel damage as a result of which fresh blood to the wound is significantly reduced.
Symptoms of predisposition to bleeding
- Severe bleeding even after minimal trauma.
- It is difficult to stop the bleeding after surgery.
- Heavy bleeding during menstruation.
- Spontaneous internal bleeding.
When haemophilia, VIII (haemophilia A) or IX (haemophilia B) blood clotting factors are absent in the blood. In mild cases, these clotting factors are available, but they are too few. Disease is hereditary and is always associated with the X-chromosome. Women rarely get sick; they transmit the disease to their male children. However, in about a quarter of all patients with haemophilia this disease can not be established in the family history. Most likely, the disease is the result of mutation of genetic information, and then it is inherited to descendants. More than three quarters of patients – with haemophilia A. Haemophilia A and B are equally dangerous, but it’s very important in the treatment to ascertain the type of haemophilia, because in case of severe bleeding intravenous injection of the missing clotting factor is required.
Treatment of haemophilia
VIII or IX concentrate clotting factor should be immediately administered to the patient if symptoms of internal bleeding. This can be done in two ways.
Doctors provide training in many patients, so they can enter the blood clotting concentrate themselves. The patient should be monitored: the frequent introduction of clotting factor concentrate can cause allergic reactions, which in the event of the introduction of the blood clotting factor is ineffective.
Patient with heavy bleeding must be treated by a doctor. After surgery or severe injury treatment can be started only with full wound healing. Otherwise there is the risk of late bleeding. Coagulation factors should be administered frequently: they are quickly broken down in the human body.
Bleeding into joints can disrupt their function, there is a danger of ankylosis. To prevent such damage haemophiliacs should exercise regularly.
Von Willebrand disease
Von Willebrand disease – a hereditary disease. In this case, just as in the case of hemophilia, there is a bleeding disorder. Symptom of the disease – a prolonged bleeding from minor wounds and cuts, bruising and haematomas after minor injuries. Heavy uterine bleeding is prevalent in women. Often hormonal contraceptives bring relief in this case. In other cases, treatment is the same as in haemophilia.
Deficiency of clotting factor
The death of the available blood clotting factors may result from autoimmune reactions that occur in patients after frequent blood transfusions. In addition, the defeat of clotting factors may result from over-stimulation of blood coagulation. Typical causes – serious injuries, some snake venoms, premature detachment of the placenta, amniotic fluid embolism, prostate cancer.
Complications or premature birth can cause bleeding disorders in newborns. However, for the normalization of blood clotting a single injection of vitamin K is often enough.
Disorders, which is associated with platelet
Thrombocytopathies – a condition, which is characterized by the presence of a normal platelet count, but not able to adequately participate in haemostasis. Symptoms – dot bruises on the skin that occur due to rupture of capillaries, bleeding from the nose and gums, in women – heavy periods and uterine bleeding in the middle of the menstrual cycle. In children, severe thrombocytopathies leads to death. But far more often the case that the hereditary factor is not the basis of a sharp decline in the platelet count or violation of their functions. Frequent bleeding is observed after reducing platelets to 100 000 per 1 ml of blood.
Thrombocytopenic purpura – an acute or chronic disease, which is based on deficiency of platelets. Acute form usually affects children or young people. In children, the disease usually appears after some infectious diseases (such as acute respiratory infection, rubella or measles). In young people, excessive bleeding occurs mainly after taking drugs. Theoretically, acute thrombocytopenic purpura can be caused by any medication. Symptoms of thrombocytopenic purpura – bleeding into the skin and bleeding from the mucous membranes. Chronic idiopathic thrombocytopenic purpura predominantly affects young women. Sometimes they have a period of exacerbation. Hemorrhage are usually not dangerous, but they can sometimes be life threatening. If the disease occurs in pregnant women, the delivery is by caesarean section.
Osler’s disease (Osler-Weber-Rendu disease) is a congenital genetic disorder, which is manifested by multiple bleeding telangiectasia (vasodilation), which are located in different parts of the skin and mucous membranes of the lips and mouth.
Predisposition to the emergence of these changes of blood vessel is congenital, but symptoms usually appear between the ages of 30-50 years. Nosebleeds occur almost daily in many patients, causing anemia. Bleeding from the mouth, digestive tract, urinary tract or vagina is possible. The most dangerous bleeding – from the lungs. When a large loss of blood, transfusions is required, sometimes the blood vessels are removed by surgery.
Moschcowitz disease are changes the blood vessels as a result of allergic reactions. Allergic alteration of the vascular wall is combined with autoimmune lesions of the hematopoietic system. There is a possibility of death. This rare allergic reaction is usually caused by drugs such as sulfonamides, penicillin, as well as drugs, which are used to treat rheumatism. There are other changes in the blood vessels, which are caused by allergic reactions, which increases the tendency to bleed. Sometimes they come with severe diseases, such as arthritis, cancer, or tuberculosis of the lungs. Blood spots often appear on the skin in the elderly. They are formed due to the fragility of the walls of blood vessels. After receiving vitamin E spots usually disappear.
Scurvy is a disease, which is caused by insufficient intake of vitamin C. Symptoms: weakness, muscle-joint pain, bleeding, tooth loss, etc. Previously, the disease was fear, but now in our area, it is quite rare. Vitamin C is involved in intracellular redox reactions, it is necessary for the synthesis of collagen, etc. Cell structure of blood vessels begin to disintegrate at deficiency of vitamin C. Dangerous bleeding in the soft tissues and joints are possible. Wound healing is disturbed. When taking vitamin C for several days, symptoms usually disappear. If scurvy is left untreated, the person dies.
If you notice bruising that appeared without a clear cause, and often bleeding wounds with hard stops bleeding, you should consult your doctor. This can be a symptom of serious illness.
The doctor will try to determine the cause of predisposition to bleeding. He has seen the patient, made laboratory blood test will reveal features of its folding, found out the presence of coagulation factors or the absence of any of them. Sometimes you have to spend expensive blood tests that are performed in special laboratories.