QS Study

Bleeding Disorders and its Diagnosis Test

Bleeding disorders are a group of conditions in which there is a difficulty with the body’s blood clotting procedure. It can cause irregular bleeding both exterior and within the body. Some disorders can severely raise the amount of blood leaving your body. Others cause bleeding to occur under the skin or in vital organs, such as the brain.

There are 3 types of bleeding disorder (B.D.)

(i) B.D. due to the vascular defect

(ii) B. D due to platelet detect

(iii) B. D due to Coagulation defect.

B.D due to vascular detects: Acquired platelet function defects are conditions that prevent clotting elements in the blood called platelets from working as they should. The term acquired means these conditions are not present at birth.

(A) Acquired: purpura Semplex, Senile purpura, Symptomatic vascular purpura, Polyarteritis nodusa.

(B) Congenital: Hereditary haemorrhagic talangiectasis, Ehlers – Danlos disease.

B.D due to platelet defect: Congenital platelet function defects are conditions that prevent clotting elements in the blood, called platelets, from working as they should. Platelets help the blood clot. Congenital means present from birth.

(i) Thrombocytopenia– Primary – Secondary; Neonatal and Congenital.

(ii) Thrombasthenia

(iii) Thrombocvthemia.

B.D. due to Coagulation defect: Disseminated intravascular coagulation is a serious disorder in which the proteins that control blood clotting become overactive.

  • Haemophilia- (i) Haemophilia A (classical haemophilia); (ii) Haemophilia B (christmas)
  • Von Willebrand’s dis

Others

Factor I deficiency; Factor II deficiency; Factor V, VII, X, XI or XII deficiency; Factor XIII deficiency. Hemophilia A and B are conditions that occur when there are low levels of clotting factors in your blood. It causes heavy or unusual bleeding into the joints.

Aquired

  • Vit K deficiency
  • Liver disease
  • DIC
  • Anticoagulant drug
  • Huge blood transfusion

Symptoms of bleeding disorders may include Easy bruising, Bleeding gums, Unexplained nosebleeds, Heavy menstrual bleeding, Bleeding into joints, Excessive bleeding following surgery etc.

Screening tests for bleeding disorder (Name of test and Normal value)

  1. Bleeding time (BT) – (i) Ivy’s method = upto 18 min; (ii) Duke’s method = upto 8 min
  2. Clotting time (CT): (i) Lee and white method = 5-11 min, (ii) Capillary tube method = 2 – 4 min
  3. Whole blood clotting time: 5-11 min [Lee and white method]
  4. Platelet count: Normal p.c = 2.5 – 4 lac/mm3
  5. Prothrombin time (PT): Normal = 12 -14 sec.
  6. Activated partial thromboplastin time (APTT): 20 – 30 see
  7. Thrombin time (Tt): Normal 10 – 14 sec
  8. Tourniquet test: Positive in thrombocvtopenia and B. D. due to vascular defect.