HEMORRHAGIC DIATHESIS - a group of diseases characterized by increased bleeding that occurs spontaneously or is triggered by an injury, including an operating one.
Distinguish between hereditary and acquired hemorrhagic diathesis . Hereditary manifestations in children (for example, hemophilia), acquired arise at any age, more often they are a complication of other diseases, for example, liver diseases, blood system with impaired platelet formation. Increased bleeding can occur with an overdose of heparin, indirect anticoagulants (phenyline, etc.), thrombolytic drugs, acetylsalicylic acid (aspirin).
There are 5 types of bleeding: hematoma, capillary (microcirculatory), mixed (hematoma and capillary at the same time), purple and microangiomatous. At the hematoma type which is characteristic for hemophilia, hemorrhages in joints are noted (see. Hemarthrosis), massive hematomas of various localization, postoperative bleeding. Capillary bleeding occurs with thrombocytopenia and thrombocytopathy. It is characterized by minor hemorrhages on the skin (petechiae and ecchymoses), nasal, gingival (see Gingivitis) and uterine bleeding, hemituria and gastric hemorrhages, hemorrhages in the brain substance are possible (see Stroke). A mixed type of bleeding is manifested by the formation of hematomas, petechial-spotted rashes on the skin, nasal, gingival and uterine bleeding. Most often, it is observed with thrombohemorrhagic syndrome, as well as with an overdose of anticoagulants. With a purple type of bleeding, minor hemorrhages are located symmetrically located mainly on the lower extremities in the form of a rash. This type of bleeding is detected in hemorrhagic vasculitis. The microangiomatous type of bleeding in the form of persistently repeated bleeding of the same localization is due to hereditary, less commonly acquired disorders in the development of small vessels.
Treatment for hereditary hemorrhagic diathesis is carried out using means that eliminate the deficit of certain factors of the blood coagulation system. Acquired hemorrhagic diathesis is treated taking into account the causes of their development. Be sure to cancel those drugs that caused bleeding, introduce antidotes.
In the prevention of hereditary hemorrhagic diathesis, genetic counseling is of great importance, and for acquired ones, the prevention of diseases that contribute to their occurrence, the rational use of drugs that reduce blood coagulation.