The true dictionary meaning of ‘diathesis’ is predisposition of the body towards a disease or group of diseases. Bleeding diathesis is an abnormal tendency to bleed. There are large numbers of disorders that have predisposition for abnormal bleeding.
In our body there are three factors which are responsible to arrest hemorrhage. They are (a) Contraction of damaged or injured blood vessels. (b) Adequate amount of platelets which helps to plug the bleeding point in damaged blood vessel. (c) Clotting mechanism in the blood. When any one or more than one of them is at fault or is deficient, our body is susceptible for abnormal bleeding.
Bleeding Diathesis Causes
Let us know the causes of bleeding diathesis:
Due to defects in the capillary wall: (Capillaries are network of tiny blood vessels through which exchange blood gasses and metabolic wastes occur).
Vascular purpura: Purpuras are tiny hemorrhagic spots or patches appearing on skin and mucus membrane. In this condition there is leakage of blood from the weakening of walls of blood vessels, mainly capillaries. Following are the factors which contribute to this condition;
- Infections such as meningitis, septicemia, dengue and other hemorrhagic fever, typhoid etc.
- Many drugs and chemicals are also responsible to cause abnormal tendency to bleed. Aspirin, quinine, phenylbutazone are some of them. Even snake venom can lead to defect in the capillary wall and abnormal bleeding.
- Senile purpura is a benign condition which occurs as a result of old age. The skin becomes too thin and small vessels underneath the skin may rupture due to minor trauma. Tiny blood patches are seen on back of hand.
- Scurvy is caused as a result of vitamin C deficiency. Vitamin C helps to strengthen the vessel wall. Deficency of vtamin C thus leads to capillary hemorrhage and reduces the stickiness of platelets.
- Cushing’s disease, prolonged corticosteroid therapy, hepatic failure, Von Willebrand disease are few other medical conditions that can give rise to purpura and abnormal bleeding.
- Deficiency of blood platelets is also responsible for bleeding diathesis. Platelets produce a substance called thromboplastin which helps the blood to clot when there is hemorrhage. It also plays a mechanical role in plugging the bleeding blood vessel. In certain conditions such as leukemia a type of blood cancer where platelets are not formed in bone marrow can lead to abnormal bleeding.
- Deficiency of vitamin K is also known to cause massive bleeding.
- Bleeding diathesis can also occur as a result of genetic condition. In this the person does not have the genes which are necessary to produce clotting of blood. There is defect in clotting mechanism. Examples of genetic disorders responsible for bleeding diathesis are Hemophilia and Christmas disease.
Symptoms Of Bleeding Diathesis
Purpura which in itself is not a disease but a manifestation of a disease is most common symptom of bleeding diathesis. Purpuras are red or purple spots or patches which are seen under the skin or mucus membrane when the blood leaks from the capillary. They do not disappear on pressure. Tiny purpuric hemorrhages just the size of pin head is called petichea. They are usually seen in lower legs. Petichea indicates deficiency of platelets or defect in the vessel wall.
Large hemorrhagic spots are known as ecchymoses. They are red initially and become purple after a day or two. Ecchymoses generally occur when there is defect in clotting mechanism. They occur in hemophilia and other bleeding disorders.
Other symptoms of bleeding diathesis include prolonged bleeding from minor cuts, injuries and tooth extraction. Menstrual bleeding may be excessive and prolonged. Hemorrhage from nose is also common. Blood from urine and stool is also a sign of bleeding diathesis.
Anemia is associated with bleeding diathesis because of loss of blood.
Bleeding Diathesis Treatment
Since there are many conditions which may be grouped under bleeding diathesis, the treatment will vary according to the specific disease. However, the aim remains same and that is to stop bleeding.
- The main line of treatment may include transfusion of blood, use of anticoagulant medicine and transfusion of platelet if they are reduced. If the cause of purpura is due to infection antibiotic therapy may be of value.
- Bleeding from the nose which does not stop from pressure may require packing with gauze and dressing.
- Intramuscular injections should be avoided.
- If there is bleeding in the joint, it should be splinted and lightly bandaged. Patient should take rest.