Blood disorders are the disorders that are characterized by prolonged bleeding due to abnormal coagulation. Coagulation is defined as the ability of the blood to clot. What is normal coagulation? The normal coagulation consists of three stages:
- The injured blood vessels narrows to reduce the potential loss of blood.
- The blood platelets stick to endothelial cells and then begin to stick to each other. This leads to the formation of normal blood clot.
- Activation of plasma protein in order to convert fibrinogen to fibrin to establish a mature clot.
What is abnormal coagulation?
Bleeding disorder occurs when the first two stages of coagulation functions normally, but in the third stage there is absent or decreased formation of the mature fibrin clot. Instead, a soft clot is formed. As this soft clot breaks down, the bleeding resumes.
Some of the common bleeding disorders are as follows:
1. Hemophilia A and B
Hemophilia is one of the most common bleeding disorders which is characterized by the deficiency of factor VIII and factor IX. It is an X linked recessive disorder. The abnormal gene that is responsible for the development of this disorder is carried on the X chromosome. Both genes for F VIII and F IX are located on the X chromosome.
Males are at high risk of developing this disease. This is because females have two X chromosomes and a female with the hemophilia gene in one of the two X chromosomes is said to be hemophilia carrier but the presence of hemophilia gene on one X chromosome may not cause her have this disease if her other X chromosome is normal and compensates. Whereas males have only one X chromosome and the presence of hemophilia gene leads to the deficiency of F VIII and F IX.
The clinical manifestation of this disease include joint and muscle bleeding. Bleeding can occur in any part of the body but the most common sites include knees, ankles, elbows, and knees. Bleeding into the areas like head, neck, abdomen, and gastrointestinal tract is considered to be life threatening.
2. Von willebrand disease
Von willebrand disease is an inherited bleeding disorder which is caused by a dysfunction of the von willebrand factor. It is a genetic disorder which occurs due to the missing or defective clotting protein in the blood known as von willebrand factor. Von willebrand disease is of three types:
- Type 1 - It is characterized by the low levels of von Willebrand factor along with the low levels of factor VIII which is another type of protein.
- Type 2 - It is characterized by the normal levels of von Willebrand factor but the problem arises when it doesn’t work in the way it should.
- Type 3 - It is characterized by very little or no production of von willebrand factor and it also has low levels of factor VIII.
Von willebrand disease is relatively common type of bleeding disorder. It is associated with the occurrence of many symptoms which include prolonged bleeding from lacerations, easy bruising, gingival bleeding, menorrhagia, and heave and prolonged bleeding after child birth.
Epistaxis, commonly known as nose bleed is the most common type of disorder. In fact, it is believed that at some point in life, up to 60 % of the population experience nose bleed and almost 6% of the population seek medical help. It is the commonly occurring problem and most cases settle with little or no treatment.
Nose bleed occurs when a small blood vessels inside the nose lining bursts and bleed. The lining of the nose consists of lots of tiny blood vessels and as the air enters the nose, the tiny blood vessels warms the air. This lining is very fragile and can easily break, resulting in bleeding. There are many causes of epistaxis such as an infection of the lining of the nostrils, cold, flu, allergy, clotting disorder, and nose picking.
4. Postpartum hemorrhage
Postpartum hemorrhage is a condition in which a woman experiences excessive bleeding after giving birth to a child. It is very normal to bleed after giving birth to baby, but excessive bleeding is not normal. It is characterized by the occurrence of a wide range of symptoms and some of the most common symptoms include uncontrolled bleeding, decreased blood pressure, increased heart rate, decreased red blood cell count, and swelling and pain in tissues in the vaginal and perineal area.
Postpartum hemorrhage is of two types - primary postpartum hemorrhage and secondary postpartum hemorrhage. Primary postpartum hemorrhage is a condition in which a woman loses excessive blood in the first 24 hours after the birth of the baby. On the other hand, secondary postpartum hemorrhage is a condition in which a woman experiences heavy bleeding between 24 hours and 12 weeks after the birth.