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Semin Thromb Hemost 2012; 38(07): 711-719
DOI: 10.1055/s-0032-1326783
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Approach to the Diagnosis and Management of Common Bleeding Disorders

Natalia Rydz
1   Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
,
Paula D. James
2   Division of Hematology, Queen's University, Kingston, Ontario, Canada
› Author Affiliations
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Publication History

Publication Date:
01 September 2012 (online)

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Abstract

Mild mucocutaneous bleeding symptoms are common in the general population. Differentiating normal from pathological bleeding complaints begins with a detailed bleeding history that assesses: the pattern (primary versus secondary hemostasis), the severity, and the onset (congenital versus acquired) of bleeding. Bleeding assessment tools have been developed to aid in determining whether bleeding symptoms are outside of the normal range. Although the clinical pattern of bleeding and family history directs laboratory investigations, von Willebrand disease, the most common and best characterized of the primary hemostatic disorders, is often the first diagnosis to be considered. Clinical management focuses on the particular symptoms experienced by the patient. Medical interventions include replacement of the factor that is deficient or defective, or indirect treatments, such as antifibrinolytics (tranexamic acid), desmopression, and hormone-based therapy (e.g., oral contraceptive pill for menorrhagia).

Keywords

mucocutaneous bleeding - bleeding scores - bruising - epistaxis - menorrhagia - von Willebrand disease - hemophilia - platelet function disorder