The Conversation – 26th July 2017
By Maher Gandhi and Huyen Tran
While blood is essential for human life, there are many things that can go wrong. And as it travels around the body and flows through every organ, problems in the blood can have wide-ranging implications for our health. There are countless problems that can occur in this vital fluid; here, we’ll have a look at the most common – bleeding disorders, clotting disorders and blood cancers.
If our blood vessels are damaged in some way, the blood contains platelets and many clotting factors (or proteins) that will form a clot in order to stem blood loss from our veins. If the number or function of these platelets or clotting proteins is reduced, this will lead to a “bleeding disorder”.
Platelets are produced by the marrow in our bones, and clotting factors by our liver. Both are affected by our individual genetic makeup. Therefore genetic abnormalities that adversely affect the function of either organ can result in bleeding disorders. Major trauma to blood vessels can also cause excessive bleeding that requires surgery.
Patients with disorders of their platelets typically present with bruises, fine spots on the limbs or trunk, or recurrent nose or gum bleeds (called “muco-cutaneous bleeding”).
Those with deficiencies in clotting factors may have joint, muscle or critical organ bleeds such as an intracranial haemorrhage (a bleed inside the skull). Women can present with excessive menstrual bleeding. Patients with a hereditary bleeding disorder often have a family history of excessive bleeding. Those patients with milder forms of bleeding disorders might present with excessive bleeding for the first time only after surgical procedures or major trauma.
The diagnosis of bleeding disorders is complex and requires a careful assessment for an excessive bleeding history, the presence (or absence) of a family history, and extensive laboratory evaluation of the platelet and clotting factors by a blood specialist, called a haematologist.