Bleeding Disorders

Classification

Disorders of primary haemostasis ( platelet disorders )

Disorders of coagulation.

 Disorders

of primary haemostatsis

Decrease in platelet number thrombocytopenia

Decrease in platelet function

THROMBOCYTOPENIA

Normal platelet count- 1.5-4lakhs/cumm

80,000/cumm no clinical defect

40,000/cumm- post traumatic bleeding

< 20,000/cumm-spontaneous haemorrhage

<10,000/cumm- intracranial bleeding

Classification based on pathogenesis

Platelet Production failure aplastic anemia, marrow

infiltration, megaloblastic anemia

Increased platelet destruction ITP, drug

induced,infections(HIV), DIC,TTP,HUS.

Platelet sequestration - hyperslenism

Dilutional

 Clinical

Features

Petichiae

purpura

ecchymosis

mucosal bleeding,joint bleeding,

muscle hematoma

bleeding after surgery.

 Basic

Investigations

Platelet count : 1.5 lakh to 4 lakh

Bleeding time : 2 to 8 min

Clotting time : 4 to 10 min

Protrombin time: 10 to 15 seconds

Activated partial thromboplastin time: 30 to 40 seconds

HEMOPHILIA

Disease caused due to defect in the clotting factors.

Two types Hemophilia A and B

Hemophilia A Factor VIII

Hemophilia B Factor IX

Both are identical clinically , they differ only in the type of

factor which is deficient.

Sex linked inherited defect

Clinical Features :
Spontaneous

Bleeding

haemorrhage

into the joints ( hemarthrosis )

Repeated

attacks of joint bleeding.

 Platelet

PT

count normal

normal

APTT

prolonged

Treatment : Replacement of clotting factor

ITP
Acute

1.Spontaneous remitting type

2.Children

3.Follows viral(measles,rubella, EBV)

infection

 Chronic

1. Idiopathic or secondary

2.All ages

3.CLL, Lymphoma,SLE, RA

 Clinical

features :

Epistaxis
Easy

bruising

Gum

bleeding

Hematuria

Thank you