WordNet

constitutional predisposition to a particular disease or abnormality
of or relating to a hemorrhage (同)haemorrhagic

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/04/20 07:57:53」(JST)

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In medicine (hematology), bleeding diathesis (h(a)emorrhagic diathesis) is an unusual susceptibility to bleed (hemorrhage) mostly due to hypocoagulability, in turn caused by a coagulopathy (a defect in the system of coagulation). Several types are distinguished, ranging from mild to lethal. Also, bleeding diathesis can be caused by thinning of the skin or impaired wound healing.^[1]

Symptoms

Symptom	Disorders
Petechiae (red spots)	Wiskott-Aldrich syndrome, where they may resemble a few bruises^[2] Acute leukemia^[3] Chronic leukemia^[3] Vitamin K deficiency^[4]
Purpura and ecchymoses	Acute leukemia^[3] Chronic leukemia^[3] Vitamin K deficiency^[4]
Blood in stool	Wiskott-Aldrich syndrome, especially in infancy^[2] Acute leukemia^[3]
Bleeding gingiva (gums)	Wiskott-Aldrich syndrome^[2] Acute leukemia^[3] Chronic leukemia^[3]
Prolonged nose bleeds	Wiskott-Aldrich syndrome^[2]

Causes

While there are several possible causes, they generally result in excessive bleeding and a lack of clotting.

Acquired

Acquired causes of coagulopathy include anticoagulation with warfarin, liver failure, Vitamin K deficiency and disseminated intravascular coagulation.Additionally, the haemotoxic venom from certain species of snakes can cause this condition, for example Bothrops, rattlesnakes and other species of viper. Viral hemorrhagic fevers include dengue hemorrhagic fever and Dengue Shock Syndrome

Leukemia may also cause coagulopathy. Furthermore, cystic fibrosis has been known to cause bleeding diathesis, especially in undiagnosed infants, due to malabsorption of fat soluble vitamins like Vitamin K.

Autoimmune causes of acquired coagulation disorders

There are autoimmune causes of coagulation disorders. They include acquired antibodies to coagulation factors, termed inhibitors of coagulation. The main inhibitor is directed against clotting Factor VIII. Another example is antiphospholipid syndrome an autoimmune, hypercoagulable state.

Causes other than coagulation

Bleeding diathesis may also be caused by impaired wound healing (as in scurvy), or by thinning of the skin, such as in Cushing's syndrome .

Genetic

Some people lack genes that typically produce the protein coagulation factors that allow normal clotting. Various types of Hemophilia and von Willebrand disease are the major genetic disorders associated with coagulopathy.Rare examples are Bernard-Soulier syndrome, Wiskott-Aldrich syndrome and Glanzmann's thrombasthenia.

Diagnosis

Comparing coagulation tests

Laboratory findings in various platelet and coagulation disorders
Condition	Prothrombin time	Partial thromboplastin time	Bleeding time	Platelet count
Vitamin K deficiency or warfarin	Prolonged	Normal or mildly prolonged	Unaffected	Unaffected
Disseminated intravascular coagulation	Prolonged	Prolonged	Prolonged	Decreased
Von Willebrand disease	Unaffected	Prolonged or unaffected	Prolonged	Unaffected
Haemophilia	Unaffected	Prolonged	Unaffected	Unaffected
Aspirin	Unaffected	Unaffected	Prolonged	Unaffected
Thrombocytopenia	Unaffected	Unaffected	Prolonged	Decreased
Liver failure, early	Prolonged	Unaffected	Unaffected	Unaffected
Liver failure, end-stage	Prolonged	Prolonged	Prolonged	Decreased
Uremia	Unaffected	Unaffected	Prolonged	Unaffected
Congenital afibrinogenemia	Prolonged	Prolonged	Prolonged	Unaffected
Factor V deficiency	Prolonged	Prolonged	Unaffected	Unaffected
Factor X deficiency as seen in amyloid purpura	Prolonged	Prolonged	Unaffected	Unaffected
Glanzmann's thrombasthenia	Unaffected	Unaffected	Prolonged	Unaffected
Bernard-Soulier syndrome	Unaffected	Unaffected	Prolonged	Decreased or unaffected
Factor XII deficiency	Unaffected	Prolonged	Unaffected	Unaffected
C1INH deficiency	Unaffected	Shortened	Unaffected	Unaffected

Treatments

Complications

Following are some complications of coagulopathies, some of them caused by their treatments:

Complication	Disorders
Soft tissue bleeding, e.g. deep-muscle bleeding, leading to swelling, numbness or pain of a limb.	Hemophilia^[5] Von Willebrand disease ^[6]
Joint damage, potentially with severe pain and even destruction of the joint and development of arthritis	Hemophilia^[5] Von Willebrand disease ^[6]
Retinal bleeding	Acute leukemia^[3]
Transfusion transmitted infection, from blood transfusions that are given as treatment.	Hemophilia^[5]
Adverse reactions to clotting factor treatment.	Hemophilia^[5]
Anemia	Von Willebrand disease ^[6]
Exsanguination (bleeding to death)	Von Willebrand disease ^[6] Acute leukemia^[3] Vitamin K deficiency^[4]
Cerebral hemorrhage	Wiskott-Aldrich syndrome^[2]

References

^ Amin, Chirag; Sharathkumar, Anjali; Griest, Anne (2014-01-01). "Bleeding diathesis and hemophilias". Handbook of Clinical Neurology. 120: 1045–1059. doi:10.1016/B978-0-7020-4087-0.00070-X. ISSN 0072-9752. PMID 24365370.
^ ^a ^b ^c ^d ^e Wiskott-Aldrich Syndrome The International Patient Organisation for Primary Immunodeficiencies (IPOPI).
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ Disorders of thrombosis and hemostasis: clinical and laboratory practice. Page Rodger L. Bick. Edition 3, illustrated. ISBN 0-397-51690-8, ISBN 978-0-397-51690-2. 446 pages
^ ^a ^b ^c Vitamin K Deficiency eMedicine. Author: Pankaj Patel, MD. Coauthor(s): Mageda Mikhail, MD, Assistant Professor. Updated: Dec 18, 2008
^ ^a ^b ^c ^d Hemophilia Complications By Mayo Clinic staff. May 16, 2009
^ ^a ^b ^c ^d Von Willebrand disease --> Complications By Mayo Clinic staff. Feb. 7, 2009

UpToDate Contents

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1. 出血性素因を有する成人患者へのアプローチ approach to the adult patient with a bleeding diathesis
2. 妊娠していない生殖可能年齢の女性における不正子宮出血に対するアプローチ approach to abnormal uterine bleeding in nonpregnant reproductive age women
3. 出血症状を有する小児に対するアプローチ approach to the child with bleeding symptoms
4. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock
5. 思春期における異常子宮出血：鑑別診断およびアプローチ abnormal uterine bleeding in adolescents differential diagnosis and approach

English Journal

Vascular cognitive impairment.

Farooq MU, Gorelick PB.SourceMedical Director, Stroke and Vascular Neurology, Hauenstein Neuroscience Center, 220 Cherry Street SE, Grand Rapids, MI, 49503, USA, farooqmu@trinity-health.org.
Current atherosclerosis reports.Curr Atheroscler Rep.2013 Jun;15(6):330. doi: 10.1007/s11883-013-0330-z.
Vascular cognitive impairment (VCI) is a term used to capture the entire spectrum of cognitive impairment from mild to more severe forms and includes all forms of stroke (e.g., ischemic and hemorrhagic forms) associated and underlying cognitive impairment related with subclinical vascular brain inju
PMID 23612956

Expression of Shiga toxin 2e glycosphingolipid receptors of primary porcine brain endothelial cells and toxin-mediated breakdown of the blood-brain barrier.

Meisen I, Rosenbrück R, Galla HJ, Hüwel S, Kouzel IU, Mormann M, Karch H, Müthing J.SourceInstitute for Hygiene, Robert-Koch-Str. 41.
Glycobiology.Glycobiology.2013 Jun;23(6):745-59. doi: 10.1093/glycob/cwt013. Epub 2013 Feb 21.
Shiga toxin (Stx) 2e, released by certain Stx-producing Escherichia coli, is presently the best characterized virulence factor responsible for pig edema disease, which is characterized by hemorrhagic lesions, neurological disorders and often fatal outcomes. Although Stx2e-mediated brain vascular inj
PMID 23431059

Urological surgery in patients with hemorrhagic bleeding disorders Hemophilia A, Hemophilia B, von Willebrand disease: a retrospective study with matched pairs analysis.

Rogenhofer S, Hauser S, Breuer A, Fechner G, Mueller SC, Oldenburg J, Goldmann G.SourceDepartment of Urologie, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany, Sebastian@Rogenhofer.de.
World journal of urology.World J Urol.2013 Jun;31(3):703-707. Epub 2012 Nov 21.
PURPOSE: To determine retrospectively the perioperative management and outcome of transurethral prostate/bladder surgery (TURP, TURB) and transrectal prostate biopsy in hemophiliacs.METHODS: Thirty-seven hemophilic patients underwent TURP (12 patients), TURB (13 patients), or transrectal prostate bi
PMID 23179730

Japanese Journal

出血傾向 (日常診療でよくみる症状・病態--診断の指針・治療の指針) -- (全身の症候)

渡部芳子
綜合臨床 60(-), 901-905, 2011-05
NAID 40018860186

アフェレシス療法が有効であったMPO-ANCA関連血管炎の2症例

福家吉伸,石原有子,北井真貴,鈴木緑,奈倉千苗美,藤井由季,丸山高史,岡田一義,藤田宜是,松本紘一
日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 43(4), 387-392, 2010-04-28
ANCA関連血管炎において，単純血漿交換（PEX）や二重濾過血漿交換法（DFPP）は重症例で施行され，その有効例が報告されている．一方，PEXによるアレルギー反応やDFPPによる出血傾向，感染症の増悪などの重篤な副作用をひき起こす場合があり，その施行には十分な検討が必要と考えられる．症例1は75歳，男性，MPO-ANCA関連血管炎に急速進行性糸球体腎炎（RPGN）および肺胞出血を併発したため，ステ …
NAID 10026316876

Related Pictures

★リンクテーブル★

リンク元	「出血傾向」「haemorrhagic diathesis」「出血性素因」
拡張検索	「albinism-hemorrhagic diathesis syndrome」
関連記事	「diathesis」「hemorrhagic」

「出血傾向」

Bleeding diathesis
Classification and external resources
Specialty	hematology
ICD-10	D69.9
ICD-9-CM	287.9
DiseasesDB	1442
MeSH	D006474
	[edit on Wikidata]

　　[★]

英: bleeding tendency
同: 出血性素因(出血素因、出血性素質) hemorrhagic diathesis
関: 血小板、凝固系、線溶系、出血傾向、血友病。出血性疾患

一次止血障害

血小板数の減少　→　出血時間↑
血小板機能異常　→　出血時間↑
血管壁の異常　　→　血管抵抗性試験悪化

二次止血障害

凝固異常　　　　→　凝固時間↑
線溶亢進　　　　→　凝固時間↑

出血傾向と症状

	血小板・血管壁の異常	凝固異常	線溶異常
出血部位	体表部(皮膚・粘膜)	深部(皮下・筋肉・関節)	深部組織に多い
出血徴候	点状出血・小斑状出血	大斑状出血・後出血	後出血・漏出性出血
特徴	小さな傷でも出血するが圧迫で容易に止血しやすい	じわじわ出血がすすみ、局所止血で止まりにくい	一旦出血が止まった後に再出血する

出血部位による鑑別診断

出血症状	血小板、血管壁の異常	凝固因子の異常
点状出血	誘発する	少ない
粘膜出血	誘因なしに見られる	機械的刺激、外傷の後に見られることが多い
筋肉・関節内出血	基本的になし	特徴的
外傷、手術後の出血	直後から見られる	しばらくたってから見られる。

疫学

播種性血管内凝固症候群は1年間に3万人以上。
特発性血小板減少性紫斑病は1年間に 500-2,000人くらいが発病。有病率は人口10万対約12人。
血友病Aは男子出生人口10万対5-10人。
血友病Bはその約1/5。

「haemorrhagic diathesis」

　　[★]

出血傾向、出血性素因

関: bleeding tendency、hemorrhagic diathesis

「出血性素因」

　　[★]

diathesis
英: hemorrhagic diathesis
関: 出血傾向

「albinism-hemorrhagic diathesis syndrome」

　　[★] ヘルマンスキー・プドラック症候群。出血型白皮症候群

「diathesis」

　　[★]

n.

(ある病気にかかりやすい)素質、体質、素因

The combination of dipyridamole and warfarin can be used to inhibit thrombus formation on prosthetic heart valves, while the combination of dipyridamole and aspirin can be used to reduce the likelihood of thrombosis in patients with a thrombotic diathesis(PPC.401)

関: diathetic, disease susceptibility, ground, predisposition

「hemorrhagic」

　　[★]

adj.

出血性の、易出血性の

関: haemophilic、haemorrhagic、hemophilic

[1] Amin, Chirag; Sharathkumar, Anjali; Griest, Anne (2014-01-01). "Bleeding diathesis and hemophilias". Handbook of Clinical Neurology. 120: 1045–1059. doi:10.1016/B978-0-7020-4087-0.00070-X. ISSN 0072-9752. PMID 24365370.

[was-2] Wiskott-Aldrich Syndrome The International Patient Organisation for Primary Immunodeficiencies (IPOPI).

[bick-3] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ Disorders of thrombosis and hemostasis: clinical and laboratory practice. Page Rodger L. Bick. Edition 3, illustrated. ISBN 0-397-51690-8, ISBN 978-0-397-51690-2. 446 pages

[emedicine-4] Vitamin K Deficiency eMedicine. Author: Pankaj Patel, MD. Coauthor(s): Mageda Mikhail, MD, Assistant Professor. Updated: Dec 18, 2008

[mayo-hemophilia-5] Hemophilia Complications By Mayo Clinic staff. May 16, 2009

[mayo-vwd-6] Von Willebrand disease --> Complications By Mayo Clinic staff. Feb. 7, 2009

匿名

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案内

案内

hemorrhagic diathesis