Under normal circumstances, bleeding after an injury stops after some time due to the clotting process called coagulation. The clotting process is interplay of various proteins in the blood called clotting factors (i.e. coagulation factors). And when clotting fails, serious consequences follow.
Coagulopathy is a condition in which the blood’s ability to clot is compromised. In other words, coagulopathy is generally a bleeding disorder. Prolonged or excessive bleeding may occur following a trauma, an injury, or a medical procedure, and may also occur naturally in cases when the coagulopathy becomes a primary medical condition or as a complication to an underlying disease or disease process.
Essentials About Coagulopathy
Here are the ten things to know about coagulopathy:
1. Coagulopathy may be inherited
There are people who are born with defects in the chemical pathways that cause blood to clot. In virtually all cases of inherited bleeding disorder, both parents must be carriers of a particular bleeding disorder in order for a person to be affected. In strict medical terms, an inherited coagulopathy is called bleeding diatheses.
Hemophilia (A and C), Christmas disease, von Willebrand’s disease, Bernard-Soulier syndrome (inherited platelet defect), and other blood factor deficiencies are example of bleeding disorders that may be passed on from parents to their children.
2. Coagulopathy may be acquired
Any interference with the complex chain of clotting factors (there are approximately 20 clotting factors) and cells (platelet) may lead to an acquired coagulopathy.
Examples of conditions that may impair clotting factors and eventually lead to a bleeding disorder include bone marrow suppression, long term use of antibiotic, Cushing syndrome, aftereffects of massive blood transfusion, insect and snake bite, ionizing radiations (e.g. X-rays, gamma rays), and use of drugs such as steroids, warfarin, aspirin, and quinine among others.
3. Inherited coagulopathy (bleeding diatheses) occur only in men
Women have two X chromosomes (XX), while men have one X chromosome and a much smaller Y chromosome. Serious bleeding diatheses are X-linked disorders, thus they may only occur in males. Why is that so?
A defective X chromosome carries particular abnormalities. When a defective X chromosome is passed on, a female, who has two X chromosomes, can compensate for the defective X chromosome because it has two X chromosomes. The case is different in males. When a trait or disorder is passed on through the defective X chromosome, it eventually expresses itself as a dominant trait in male due to the absence of another X to mask or compensate for the defective X chromosome. Statistically, one half of sons will have the disorder, and one half of daughters will be carriers of the disorder.
4. Coagulopathy may be a complication resulting from a disease
It is called disseminated intravascular coagulation or coagulation consumption coagulopathy. It is bleeding abnormality caused by a primary medical condition. Ergo, it is not a disease. It is a complication resulting from an underlying disease.
Examples of diseases and disease process that may exacerbate coagulation consumption coagulopathy are AIDS, aplastic anemia, hepatic failure, renal failure, leukemia, vitamin K deficiency, scurvy, and typhus among others.
5. Symptoms of coagulopathy as a primary medical condition
An acquired coagulopathy (aka bleeding diatheses) due to long-term use of certain drugs (e.g. antibiotics, steroids, warfarin, etc.) may damage a few of the clotting factors needed for a normal clotting process. In such case, symptoms of coagulopathy include excessive bleeding, or prolonged bleeding after a medical procedure.
The following symptoms may occur naturally or after certain medical procedures such as surgery or dental intervention:
- Develop petechiae or purpura (red or dark blue marks on the skin)
- Scurvy (gum bleeding)
- Painful joints
- Easy bleeding or bruising
- Abnormal menstruation
- Very frequent nosebleeds
The symptoms vary according to the severity and nature of the coagulopathy. Be mindful.
6. Symptoms of coagulopathy as a complication or an aftereffect of injury or a procedure
Bleeding is expected after a medical procedure such as surgery, excessive and/or extended bleeding, however, is a symptom of coagulopathy. Excessive or extended bleeding may occur after a dental procedure, minor trauma or cut, receiving an injection (shot), or a surgery. Seek medical attention in cases such as these.
7. Coagulopathy may lead to joint bleeding
Coagulopathy may cause the joints to bleed. When the joint feels hot to the touch, painful, swelling, tight and movement is reduced (e.g. range of motion of the joint) it may be a sign that the bleeding is occurring in your joints. Commonly, this can be observed in the knees and the elbows.
8. Serious coagulopathy, life-threatening symptoms
In extreme cases, coagulopathy may cause serious internal bleeding and that is life threatening. Serious symptoms of life-threatening coagulopathy include hematuria (bloody urine), bloody stool, unconsciousness, seizures, memory loss, weakness of extremities, difficulty walking or speaking, loss or change in vision, and/or repeated vomiting. Seek immediate medical attention in circumstance the aforementioned symptoms are observed.
9. Treatment for coagulopathy includes replacing clotting factors
Coagulopathy treatment seeks to improve the clotting process of the blood. There are specific treatments that depend on the cause and nature of the coagulopathy. Treatment to correct the clotting process targets replacement of defective clotting factors. Seek a doctor’s guidance.
10. Complications of coagulopathy can be serious
Coagulopathy as a primary medical condition could also lead to other disorders or far serious medical condition. Prompt treatment when bleeding begins is important to prevent further injury or damage. Complications of untreated coagulopathy can be serious, even life threatening, such as anemia, deep internal bleeding, and joint deformity or destruction.
The old adage puts it: “Prevention is better than cure.” Do not take your health for granted. Be mindful of what you eat, do, and feel. If you notice irregularities in your body, do not take them for granted and seek expert medical advice.
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