When it comes to increased bleeding of the body and its tendency to spontaneous bleeding or the development of hemorrhages where the traumatic effect was very small, inadequate to the resulting hematoma, we can talk about hemorrhagic diathesis. This term is used to combine some syndromes that develop due to hemostasis disorders, and such disorders can be congenital or develop as a result of certain diseases. The problems of hemorrhagic diathesis are dealt with by doctors of a number of specialties, since various pathologies can become the cause of increased bleeding.
Why can hemorrhagic diathesis develop
Hemorrhagic diathesis is usually divided into two main groups - primary and secondary. The primary ones include those forms of the disease that are caused by congenital pathology, a defect or an insufficient amount of one of the coagulation factors. Sometimes we can talk about multifactorial pathology – for example, when in von Willebrand's disease there is a defect in the production of factor VIII, as well as problems with vascular factor and platelet adhesiveness.
The cause of hemorrhagic diathesis may be a violation of the vascular endothelium, a change in the properties of some hemostasis factors or their increased consumption or improper synthesis.
Hemorrhagic diathesis develops in some internal diseases – such as cirrhosis of the liver, dengue fever, infective endocarditis, systemic lupus erythematosus. The cause of hemorrhages on the skin can be a deficiency in the body of vitamin K, vitamin C, as well as inadequate anticoagulant therapy.
Among acquired or secondary hemorrhagic diathesis, a special place is occupied by disseminated intravascular coagulation, which can occur in various branches of medicine – from traumatology to obstetrics – and represents a hyperprotective reaction of the body to damage to blood vessels in order to isolate it from damage.
The cause of hemorrhagic diathesis can be autoimmune thrombocytopenia, hemorrhagic vasculitis, leukemia, radiation sickness.
How does hemorrhagic diathesis manifest itself in patients
The types of manifestations of hemorrhagic diathesis differ from each other, and these differences depend on the causes that caused it, as well as concomitant pathologies. Symptoms in different forms of the disease are as follows:
microcirculatory – dotted and spotted rashes on the skin, hemorrhages in the mucous membranes (for example, after tooth extraction), occurs with thrombocytopenia, occurs with slight pressure on the skin;
hematoma – deep painful hematomas occurring in soft tissues, with massive hemorrhages, can cause tissue separation, occur with hemophilia, can be spontaneous or develop after injury;
mixed – occurs when the allowed dose of administered anticoagulants is exceeded and looks like a combination of petechial hemorrhages and deep hematomas;
microangiomatous – characterized by persistent bleeding (for example, from the nose), the cause is angiomatosis;
vasculitic purple – symmetrical eye hemorrhages on the trunk and extremities, after disappearance, leave pigmentation and become the cause of anemia.
Special symptoms of hemorrhagic diathesis and their meaning
The course of hemorrhagic diathesis is often accompanied by the development of iron deficiency anemia. The patient has pale skin and complains of lethargy, weakness, dizziness. Examination revealed tachycardia and low blood pressure. Some forms of hemorrhage cause swollen joints, nausea, back pain, dysuria.
Thus, when choosing therapy for a patient with hemorrhagic diathesis, it is very important to determine the cause of its development and the form of hemorrhage, the nature of the lesion of internal organs and comorbidities in order to develop an optimal treatment regimen.
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