Hemorrhagic diathesis: symptoms and causes
The successful functioning of a living organism directly linked to the efficient functioning of circulatory system. Any damage in hemostasis (a complex of reactions designed to stop bleeding) require consultation of a hematologist.
One of the most common hematologic dysfunction is hemorrhagic diathesis. This is a group of diseases that are characterized by abnormal bleeding and tendency to bleeding.
Classification of hemorrhagic diathesis
The disease is of primary or secondary origin. In the first case it is a congenital pathology, in the second — a consequence of triggering factors:
- Chemotherapy, radiation exposure, radiation sickness;
- Immune disorders;
- Severe intoxication;
- A deficiency of vitamins C and K;
- Long-term use of anticoagulants, corticosteroids;
- Liver disease (obstructive jaundice, cirrhosis, hepatitis);
- Leukemias and malignant processes;
- Diabetes, amyloidoses;
- Sepsis, meningitis;
A hereditary form of hemorrhagic diathesis is incurable, but amenable to medicines. Drugs reduce symptoms and facilitate the patient's condition. Therapy of acquired forms is to cure the underlying disease.
Division diathesis origin
Abnormal bleeding occurs for three main reasons, leading to various dysfunctions of the blood and (or) the hematopoietic system:
- Violation of the mechanism of blood clotting (hemophilia).
- Changes in the composition of blood, namely decrease in the number of platelets or disruption of their livelihoods (thrombocytopathy, thrombocytopenia, bone marrow aplasia, idiopathic thrombocytopenic purpura disease).
- Increased vascular permeability (hemorrhagic vasculitis, hemangiomas, erythema, hemorrhagic fever, congenital telangiectasia).
All of these hemorrhagic diathesis may exist both separately and in combination.
Main symptoms of the disease
Initial symptoms of the disease appear from the first days of life. Persistently bleeding in the newborn umbilical wound, the baby's gums during teething. In the future, the parents have to involve prolonged bleeding in places, scratches and cuts.
Removal and even regular tooth causes severe blood loss, so hemorrhagic diathesis in children, accompanied by severe anemia.
In milder injuries, is pinched, the pressure in the subcutaneous tissue and muscles arise large hematoma.
style="font-size: medium;">Classification of hemorrhagic diathesis includes five main types of diathesis:
- Microcirculatory (capillary). When thrombocytopenia is found. Patients get a blue-red or bright-red, symmetrical rash on the front of the thighs, legs, feet, rarely of the forearms. In severe disease rash ulcerate.
The basis of the phenomenon lies kapilliarotoxicos violation of the permeability of the capillary walls, through which leak red blood cells. The same rash appears on the mucosa of internal organs.
- Hematomic. Characteristic of hemophilia. It marked a painful intense bleeding in the peritoneum, joints, muscles, subcutaneous tissue. Articular hemarthrosis accompanied by high fever, pain, swelling and limitation of joint mobility. When the cause of the hemorrhagic diathesis is a blood clotting disorder, prior to any intervention requires the introduction of drugs, excluding large blood loss.
- Mixed (capillary and hematomic). Often observed in overdose of anticoagulant agents and thrombohemorrhagic syndrome. On the skin are small hemorrhages (petechiae, ekhimozy) start of masterbatch, gingival, nasal bleeding.
- Purple. Is the hallmark of hemorrhagic vasculitis. On the extensor surfaces of the extremities appears small, symmetrical rash.
- Mikroangiomatozny. Mainly due to congenital lesions of the small vascular. Characterized by persistent bleeding, a local character (in places considerable damage to the vascular wall).
The acute syndromes of the disease
- The sharp attacks of abdominal pain accompanied by vomiting with blood;
- Gastrointestinal and renal bleeding;
- The appearance of blood in the urine and feces;
- Swelling of the face and hands, a rash in the form of urticaria;
- Blue-red spots at the injection sites;
- Bruises on the face and in the whites of the eyes. These symptoms of the hemorrhagic diathesis talking about the very real threat of bleeding in the retina or in the brain.
Nature took care of the safety of childbirth — during childbirth the hemorrhagic bleeding does not happen. But in the postpartum period of possible massive blood loss.
The determination of the diagnosis
The aim of the diagnostics is to ascertain the form, extent and causes increased bleeding. A hematologist is a plan examination of the patient with the attending physician, which revealed pathology (surgeon, obstetrician, surgeon, etc.).
Is assigned a range of laboratoryresearch:
- A blood test for the platelet count;
- The stool test for occult blood.
Based on the data and tentative diagnosis, prescribe advanced survey:
- Biochemical analysis of blood;
- Aspiration puncture of the Ilium;
- Sternal puncture;
- Biopsy (if the two previous procedures did not give a clear picture of the condition of the bone marrow);
- Functional tests for capillary fragility (pinch, overlap, cuffs or harness);
- Ultrasound of the kidneys and liver;
- Radiography of the joints.
To confirm the congenital forms of dysfunction a patient's guide to consult a geneticist.
Methods of treatment
In selecting therapy, the extent, form and type of disease. If there is a deficiency of any clotting factors, treatment hemorrhagic diathesis is as follows:
- Replacement therapy with the introduction of concentrates of the missing blood components.
- Transfusion of platelets and Packed red cells, fresh frozen plasma (rapid freezing it preserves the coagulation factors).
- Hemostatic therapy in bleeding small — nose tamponade, tourniquet, pressure bandage, hemostatic sponges, ice.
In case of violation of capillary permeability are appointed injections of menadione. If the reduced blood platelet count, intravenously, and intramuscularly injected with glucocorticoids (prednisolone, metipred).
Hematomas in the joints and tissues are subject to opening. The clotted or liquid blood is removed, the cavity is rinsed with antiseptic solutions. When hemarthrosis is flushing corticosteroid means.
The development of massive blood loss suggests a more serious interventions:
- Removal of the defective blood vessel, sometimes with a subsequent replacement of the damaged section;
- Removal of the spleen (splenectomy). The operation increases the lifespan of blood cells.
- Implantation of an artificial joint, if you own irreversibly damaged by hemorrhage.
There is also a promising direction of gene therapy, like gravity surgery. Its essence lies in the correction of protein and cellular composition of the blood disturbed due to various anomalies. The patient is connected to a machine that removes from the bloodstream decay products and toxic substances. It allows you to pause the progression of the disease.
To stop the bleeding by using the following herbal remedies:class="img-right2">
- The fruit and leaves of viburnum;
- Shepherd's purse;
- Nettle leaves.
Infusions of these herbs reduce capillary fragility, improve blood clotting. Plants are rich in vitamins K and C, and also has a pronounced vasoconstrictor effect.
Preventive measures are not particularly effective when innate propensity for blood diseases. But if thus it is possible to partially stop the process, to suspend it in the early stages, it is already done.
To the prevention of diathesis are the following activities:
- Regular sessions of noninvasive types of physical training, tempering, good nutrition;
- Taking multivitamin complexes;
- Herbal medicine;
- Strict personal hygiene, reducing the likelihood of viral and bacterial infections that may trigger the pathological process;
- The prevention of diseases that contribute to the occurrence of anomalies of the circulatory system;
- Cautious use of medications that reduce blood clotting.
In the prevention of hereditary forms plays a big role of medical-genetic counseling. You should avoid marriages between people who are sick (especially among relatives), because it significantly increases the risk of having children with hemophilia.