In medicine (hematology), bleeding diathesis is an unusual susceptibility to bleed (hemorrhage) mostly due to hypocoagulability (a condition of irregular and slow blood clotting), in turn caused by a coagulopathy (a defect in the system of coagulation). Therefore, this may result in the reduction of platelets being produced and leads to excessive bleeding. Several types of coagulopathy are distinguished, ranging from mild to lethal. Coagulopathy can be caused by thinning of the skin (Cushing's syndrome), such that the skin is weakened and is bruised easily and frequently without any trauma or injury to the body. Also, coagulopathy can be contributed by impaired wound healing or impaired clot formation.
Signs and symptoms
{|class="wikitable"
! Symptom !! Disorders
|-
|Petechiae (red spots)
|
- Wiskott–Aldrich syndrome, where they may resemble a few bruises
- Acute leukemia
- Chronic leukemia
|-
| Purpura and ecchymoses
|
- Acute leukemia
- Von Willebrand disease
|-
| Exsanguination (bleeding to death)
|
- Von Willebrand disease <!-- Additional information -->
Diagnosis
Comparing coagulation tests
{| class="wikitable sortable"
|+ Laboratory findings in various platelet and coagulation disorders
! Condition
! Prothrombin time
! Partial thromboplastin time
! Bleeding time
! Platelet count
|-
| Vitamin K deficiency or warfarin
| Prolonged
| Normal or mildly prolonged
| Unaffected
| Unaffected
|-
| Disseminated intravascular coagulation
| Prolonged
| Prolonged
| Prolonged
| Decreased
|-
| Von Willebrand disease
| Unaffected
| Prolonged or unaffected
| Prolonged
| Unaffected
|-
| Hemophilia
| Unaffected
| Prolonged
| Unaffected
| Unaffected
|-
| Aspirin
| Unaffected
| Unaffected
| Prolonged
| Unaffected
|-
| Thrombocytopenia
| Unaffected
| Unaffected
| Prolonged
| Decreased
|-
| Liver failure, early
| Prolonged
| Unaffected
| Unaffected
| Unaffected
|-
| Liver failure, end-stage
| Prolonged
| Prolonged
| Prolonged
| Decreased
|-
| Uremia
| Unaffected
| Unaffected
| Prolonged
| Unaffected
|-
| Congenital afibrinogenemia
| Prolonged
| Prolonged
| Prolonged
| Unaffected
|-
| Factor V deficiency
| Prolonged
| Prolonged
| Unaffected
| Unaffected
|-
| Factor X deficiency as seen in amyloid purpura
| Prolonged
| Prolonged
| Unaffected
| Unaffected
|-
| Glanzmann's thrombasthenia
| Unaffected
| Unaffected
| Prolonged
| Unaffected
|-
| Bernard–Soulier syndrome
| Unaffected
| Unaffected
| Prolonged
| Decreased or unaffected
|-
| Factor XII deficiency
| Unaffected
| Prolonged
| Unaffected
| Unaffected
|-
| C1INH deficiency
| Unaffected
| Shortened
| Unaffected
| Unaffected
|}
Treatments
Consult a hematologist and have regular blood check ups. Have an early diagnostic test for any blood disorders or blood diseases including hemophilia, hemorrhage, and sickle-cell anemia. Prothrombin time and partial thromboplastin time blood tests are useful to investigate the reason behind the excessive bleeding. The PT evaluates coagulation factors I, II, V, VII and X, while the PTT evaluates coagulation factors I, II, V, VIII, IX, X, XI and XII. The analysis of both tests thus helps to diagnose certain disorders.
Blood transfusion involves the transfer of plasma containing all the necessary coagulating factors (fibrinogen, prothrombin, thromboplastin) to help restore them and to improve the immune defense of the patient after excessive blood loss. Blood transfusion also caused the transfer of platelets that can work along with coagulating factors for blood clotting to commence.
Different drugs can be prescribed depending on the type of disease. Vitamins (K, P and C) are essential in case of obstruction to walls of blood vessels. Also, vitamin K is required for the production of blood clotting factors, hence the injection of vitamin K (phytomenadione) is recommended to boost blood clotting.
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