In medicine

Medicine

Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 (hematology

Hematology

Hematology, also spelled haematology , is the branch of biology physiology, internal medicine, pathology, clinical laboratory work, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases...

), bleeding diathesis (or bleeding tendency or predisposition) is an unusual susceptibility to bleeding (hemorrhage) mostly due to hypocoagulability, in turn caused by a coagulopathy

Coagulopathy

Coagulopathy is a condition in which the blood’s ability to clot is impaired. This condition can cause prolonged or excessive bleeding, which may occur spontaneously or following an injury or medical and dental procedures.The normal clotting process depends on the interplay of various proteins in...

 (a defect in the system of coagulation

Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel...

). Several types are distinguished, ranging from mild to lethal. Also, bleeding diathesis can be caused by thinning of the skin or impaired wound healing

Wound healing

Wound healing, or cicatrisation, is an intricate process in which the skin repairs itself after injury. In normal skin, the epidermis and dermis exists in a steady-state equilibrium, forming a protective barrier against the external environment...

.

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

Warfarin

Warfarin is an anticoagulant. It is most likely to be the drug popularly referred to as a "blood thinner," yet this is a misnomer, since it does not affect the thickness or viscosity of blood...

, liver failure

Liver failure

Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease , and indicates that the liver has sustained severe damage . The complications are hepatic encephalopathy and impaired protein synthesis...

, Vitamin K deficiency

Vitamin K deficiency

Vitamin K deficiency is a form of avitaminosis resulting from insufficient vitamin K.-Causes:Vitamin K-deficiency may occur by disturbed intestinal uptake , by therapeutic or accidental intake of vitamin K-antagonists or, very rarely, by nutritional vitamin K deficiency...

 and disseminated intravascular coagulation

Disseminated intravascular coagulation

Disseminated intravascular coagulation , also known as disseminated intravascular coagulopathy or consumptive coagulopathy, is a pathological activation of coagulation mechanisms that happens in response to a variety of diseases. DIC leads to the formation of small blood clots inside the blood...

.

Additionally, the haemotoxic venom from certain species of snake

Snake

Snakes are elongate, legless, carnivorous reptiles of the suborder Serpentes that can be distinguished from legless lizards by their lack of eyelids and external ears. Like all squamates, snakes are ectothermic, amniote vertebrates covered in overlapping scales...

s can cause this condition e.g. Bothrops

Bothrops

Bothrops is a genus of venomous pitvipers found in Central and South America. The generic name is derived from the Greek words bothros and ops that mean "pit" and "eye" or "face"; an allusion to the heat-sensitive loreal pit organs. Members of this genus are responsible for more human deaths in the...

, rattlesnakes and other species

Species

In biology, a species is one of the basic units of biological classification and a taxonomic rank. A species is often defined as a group of organisms capable of interbreeding and producing fertile offspring. While in many cases this definition is adequate, more precise or differing measures are...

 of viper

Viperidae

The Viperidae are a family of venomous snakes found all over the world, except in Antarctica, Australia, Ireland, Madagascar, Hawaii, various other isolated islands, and above the Arctic Circle. All have relatively long, hinged fangs that permit deep penetration and injection of venom. Four...

. Viral hemorrhagic fever

Viral hemorrhagic fever

The viral hemorrhagic fevers are a diverse group of animal and human illnesses that are caused by four distinct families of RNA viruses: the families Arenaviridae, Filoviridae, Bunyaviridae, and Flaviviridae. All types of VHF are characterized by fever and bleeding disorders and all can progress...

s include dengue hemorrhagic fever and Dengue Shock Syndrome

Leukemia

Leukemia

Leukemia or leukaemia is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts". Leukemia is a broad term covering a spectrum of diseases...

 may also cause coagulopathy.

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

Antiphospholipid syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome , often also Hughes syndrome, is an autoimmune, hypercoagulable state caused by antibodies against cell-membrane phospholipids that provokes blood clots in both arteries and veins as well as pregnancy-related complications such as...

.

Genetic

Some people lack gene

Gene

A gene is a molecular unit of heredity of a living organism. It is a name given to some stretches of DNA and RNA that code for a type of protein or for an RNA chain that has a function in the organism. Living beings depend on genes, as they specify all proteins and functional RNA chains...

s that typically produce the protein

Protein

Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...

 coagulation factors that allow normal clotting. Various types of Hemophilia and von Willebrand disease

Von Willebrand disease

von Willebrand disease is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions. It arises from a qualitative or quantitative deficiency of von Willebrand factor , a multimeric protein that is required for...

 are the major genetic disorders associated with coagulopathy.

Rare examples are Bernard-Soulier syndrome

Bernard-Soulier syndrome

Bernard–Soulier syndrome , also called hemorrhagiparous thrombocytic dystrophy, is a rare autosomal recessive coagulopathy that causes a deficiency of glycoprotein Ib , the receptor for von Willebrand factor, which is important in clot formation.The incidence is estimated to be less than 1 in 1...

, Wiskott-Aldrich syndrome

Wiskott-Aldrich syndrome

Wiskott–Aldrich syndrome is a rare X-linked recessive disease characterized by eczema, thrombocytopenia , immune deficiency, and bloody diarrhea . It is also sometimes called the eczema-thrombocytopenia-immunodeficiency syndrome in keeping with Aldrich's original description in 1954...

 and Glanzmann's thrombasthenia

Glanzmann's thrombasthenia

Glanzmann's thrombasthenia is an abnormality of platelets. It is an extremely rare coagulopathy , in which the platelets lack glycoprotein IIb/IIIa...

.

Symptoms

Symptom	Disorders
Petechiae (red spots)	Wiskott-Aldrich syndrome Wiskott-Aldrich syndrome Wiskott–Aldrich syndrome is a rare X-linked recessive disease characterized by eczema, thrombocytopenia , immune deficiency, and bloody diarrhea . It is also sometimes called the eczema-thrombocytopenia-immunodeficiency syndrome in keeping with Aldrich's original description in 1954... , where they may resemble a few bruises Acute leukemia Acute leukemia Acute leukemia or acute leukaemia is a generic term used to describe a family of serious medical conditions relating to an original diagnosis of leukemia... Chronic leukemia Chronic leukemia Chronic leukemia is an increase of abnormal white blood cells. It differs from acute leukemia, and is categorized as myelogenous or lymphocytic.Chronic leukemia may refer to:* Chronic myelogenous leukemia* Chronic lymphocytic leukemia* Hairy cell leukemia... Vitamin K deficiency Vitamin K deficiency Vitamin K deficiency is a form of avitaminosis resulting from insufficient vitamin K.-Causes:Vitamin K-deficiency may occur by disturbed intestinal uptake , by therapeutic or accidental intake of vitamin K-antagonists or, very rarely, by nutritional vitamin K deficiency...
Purpura Purpura Purpura is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin...  and ecchymoses	Acute leukemia Chronic leukemia Vitamin K deficiency
Blood in stool Blood in stool In medicine, when referring to human feces, blood in stool can refer to multiple conditions:* Melena, with more blackish appearance, originating in upper parts of the gastrointestinal tract...	Wiskott-Aldrich syndrome, especially in infancy Acute leukemia
Bleeding gingiva Gingiva The gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...  (gums)	Wiskott-Aldrich syndrome Acute leukemia Chronic leukemia
Prolonged nose bleeds	Wiskott-Aldrich syndrome

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 Von Willebrand disease Von Willebrand disease von Willebrand disease is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions. It arises from a qualitative or quantitative deficiency of von Willebrand factor , a multimeric protein that is required for...
Joint damage, potentially with severe pain and even destruction of the joint and development of arthritis Arthritis Arthritis is a form of joint disorder that involves inflammation of one or more joints....	Hemophilia Von Willebrand disease Von Willebrand disease von Willebrand disease is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions. It arises from a qualitative or quantitative deficiency of von Willebrand factor , a multimeric protein that is required for...
Retinal bleeding	Acute leukemia
Transfusion transmitted infection Transfusion transmitted infection A Transfusion transmitted infection is a virus, parasite, or other potential pathogen that can be transmitted in donated blood through a transfusion to a recipient... , from blood transfusions that are given as treatment.	Hemophilia
Adverse reactions to clotting factor treatment.	Hemophilia
Anemia Anemia Anemia is a decrease in number of red blood cells or less than the normal quantity of hemoglobin in the blood. However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin...	Von Willebrand disease Von Willebrand disease von Willebrand disease is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions. It arises from a qualitative or quantitative deficiency of von Willebrand factor , a multimeric protein that is required for...
Exsanguination Exsanguination Exsanguination is the fatal process of hypovolemia , to a degree sufficient enough to cause death. One does not have to lose literally all of one's blood to cause death... (bleeding to death)	Von Willebrand disease Von Willebrand disease von Willebrand disease is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions. It arises from a qualitative or quantitative deficiency of von Willebrand factor , a multimeric protein that is required for... Acute leukemia Vitamin K deficiency
Cerebral hemorrhage	Wiskott-Aldrich syndrome Wiskott-Aldrich syndrome Wiskott–Aldrich syndrome is a rare X-linked recessive disease characterized by eczema, thrombocytopenia , immune deficiency, and bloody diarrhea . It is also sometimes called the eczema-thrombocytopenia-immunodeficiency syndrome in keeping with Aldrich's original description in 1954...

Causes other than coagulation

Bleeding diathesis may also be caused by impaired wound healing

Wound healing

Wound healing, or cicatrisation, is an intricate process in which the skin repairs itself after injury. In normal skin, the epidermis and dermis exists in a steady-state equilibrium, forming a protective barrier against the external environment...

 (as in scurvy

Scurvy

Scurvy is a disease resulting from a deficiency of vitamin C, which is required for the synthesis of collagen in humans. The chemical name for vitamin C, ascorbic acid, is derived from the Latin name of scurvy, scorbutus, which also provides the adjective scorbutic...

), or by thinning of the skin, such as in Cushing's syndrome

Cushing's syndrome

Cushing's syndrome is a hormone disorder caused by high levels of cortisol in the blood. This can be caused by taking glucocorticoid drugs, or by tumors that produce cortisol or adrenocorticotropic hormone or CRH...

.