Coagulopathy

Alternative names 
Bleeding disorders

Definition
Bleeding disorders are a group of conditions of the blood clotting (coagulation) system in which bleeding is prolonged and excessive.

Causes, incidence, and risk factors

Normal blood coagulation is a complex process involving as many as 20 different plasma proteins, which are known as blood clotting or coagulation factors. Normally, these factors interact with other chemicals to form a substance called fibrin that stops bleeding. When certain coagulation factors are deficient or missing, the process is impaired. Bleeding problems can range from mild to severe.

Some bleeding disorders are present at birth and are caused by rare inherited disorders. Others are developed during certain illnesses (such as vitamin K deficiency or severe liver disease), or treatments (such as use of anticoagulant drugs or prolonged use of antibiotics).

Bleeding disorders can also result from a decreased number of (or impaired function of) platelets, the blood cells that promote blood clotting. These disorders can also be either inherited or acquired. The acquired forms often arise from the side effects of certain drugs.

Symptoms

     
  • Excessive bleeding  
  • Excessive bruising  
  • Bleeding into joints  
  • Nose bleeds  
  • Abnormal menstrual bleeding

See also specific bleeding disorder diseases:

     
  • Hemophilia A  
  • Hemophilia B  
  • Factor II deficiency  
  • Factor V deficiency  
  • Factor VII deficiency  
  • Factor X deficiency  
  • Factor XII deficiency  
  • Idiopathic thrombocytopenic purpura (ITP)  
  • Thrombotic thrombocytopenic purpura  
  • Drug-induced immune thrombocytopenia  
  • Von Willebrand’s disease (type I and type II)  
  • Congenital antithrombin III deficiency  
  • Congenital protein C or S deficiency  
  • DIC (disseminated intravascular coagulation)

Signs and tests

     
  • Complete blood count may show decreased platelets or anemia.  
  • Prothrombin time (PT) may be prolonged.  
  • Partial thromboplastin (PTT) time may be prolonged.  
  • Bleeding time may be prolonged.  
  • Platelet aggregation test may be abnormal.

Specific abnormalities depend on the specific bleeding disorder.

Treatment
Treatment depends on the specific disorder. It may include factor replacement, fresh frozen plasma transfusion, platelet transfusion, or other therapies.

Expectations (prognosis)
Prognosis also depends on the specific disorder. Most primary bleeding disorders can be successfully managed. Those due to underlying diseases, such as DIC, depend on the success of treatment for the disease.

Complications

     
  • Severe bleeding  
  • Bleeding in the brain

Other complications can result, depending on the specific disorder.

Calling your health care provider
Call your health care provider if you notice any unusual or severe bleeding.

Prevention
Prevention depends on the specific disorder.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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