Disorders Causing Bleeding Tendency

The process of blood coagulation is extremely complex and is influenced by numerous factors. Any abnormality in the system can have serious consequences, as a disruption in coagulation can lead to bleeding or thrombosis. The background of abnormal bleeding tendencies often involves deviations in the functioning of the vascular system, platelets, or coagulation factors present in the plasma.

Disorders of the coagulation process can be traced back to very different causes. Abnormal conditions can be hereditary, arising from the genetic background of diseases, or acquired, resulting from various external influences such as medications or diseases. Understanding the causes of bleeding tendencies is essential for proper diagnosis and treatment.

Bleeding disorders often stem from hidden causes, and the symptoms encompass a wide spectrum. The underlying factors may include vascular changes, platelet disorders, or faulty functioning of coagulation factors. In the following paragraphs, we will examine these factors in detail and present the diseases that influence the coagulation process.

Disorders Causing Hemophilia

The causes behind hemophilia can be diverse, but most commonly, vascular changes, platelet disorders, and deviations in coagulation factors play a role. Vascular changes include vasculitis, which develops due to inflammation of the blood vessels. These disorders can also appear as a consequence of various hereditary diseases, such as hereditary simple purpura.

Acquired vascular changes can also contribute to hemophilia, for example, due to taking certain medications or as a result of steroid treatments. Additionally, vitamin deficiencies, such as a lack of vitamin C, can cause bleeding, often accompanied by spontaneous bleeding of the gums. In rare cases, such as palmar apoplexy, young women may experience spontaneous hematomas in the palms and fingers.

In elderly individuals, the phenomenon of senile purpura can be observed, where small hemorrhages develop due to skin thinning, often in the areas of the face, back of the hands, forearms, and shins. These spots usually leave a brownish discoloration but generally heal on their own.

Platelet Disorders

Platelets can exhibit quantitative and qualitative deviations that may cause pathological bleeding. In cases of quantitative deviations, the number of platelets is reduced, making the formation of platelet plugs insufficient to stop bleeding. This phenomenon is called thrombocytopenia, which occurs when the platelet count is less than 150,000 per microliter.

The causes of thrombocytopenia can be diverse. For instance, a decrease in platelet production may occur due to infectious diseases, nutritional deficiencies, or malignancies. Increased destruction of platelets, such as side effects of medications or immunological disorders, can also contribute to the problem.

In cases of qualitative disorders of platelets, the platelet count may be normal, but their structure is impaired, preventing them from performing their functions properly. Rare hereditary conditions, such as Glanzmann’s thrombasthenia or Bernard-Soulier syndrome, may involve dysfunctions of platelet function. In these cases, platelets cannot adequately form the plugs necessary to stop bleeding.

Deviations of Coagulation Factors

Abnormalities in coagulation factors can also cause serious problems. During coagulation, 12 coagulation factors are involved, and any malfunction or insufficient quantity of any of these can disrupt the process of stopping bleeding. Hereditary diseases, such as hemophilia A and B, are associated with deficiencies of factors VIII and IX, leading to severe hemophilia.

Additionally, there are rare congenital disorders that involve deficiencies of factors V, VII, X, XI, and XII. The absence of coagulation factors can also arise from acquired causes, such as liver diseases, as most factors are produced in the liver.

A decrease or absence of coagulation factors can therefore have serious consequences, and thorough medical examinations are necessary to establish a diagnosis. The treatment of coagulation disorders is a complex process that may involve medication therapy, blood transfusions, or even specialized treatments, depending on the type of disorder present. Prevention and early diagnosis are crucial to avoiding complications.