Bleeding Disorders

A bleeding disorder is a medical condition that affects the body’s blood clotting (or coagulation) process.  Normally, when a person is hurt, the body activates the coagulation system to form a clot at the site of injury and stop bleeding quickly.  Clot formation requires blood cells (called platelets) and blood proteins (called clotting factors).  In people with bleeding disorders, either (1) the clotting factors are low or missing, or (2) the platelets do not work properly or are in short supply.  These abnormalities cause bleeding problems, which can range from mild to severe. Causes & Symptoms Bleeding disorders can either be inherited (passed through families) or developed (acquired) during certain illnesses or over time as a side effect of specific medications.  An affected individual experiences bleeding episodes, which may result from an injury or may occur spontaneously (i.e. without a known injury).  Symptoms include the following:

• Abnormal menstrual bleeding
• Bleeding into joints, muscles, and soft tissues
• Bleeding internally, in abdomen kidneys, and intestines
• Excess bruising
• Heavy bleeding
• Nose bleeds

Bleeding Disorder Categories There are several types of bleeding disorders, many of which are named for the specific clotting factor that is deficient. Hemophilia is the best-known inherited bleeding disorder.  There are two main types:

1. Hemophilia A, also called Factor VIII hemophilia, is caused by a lack of the blood clotting factor VIII.
2. Hemophilia B, also called Factor IX hemophilia or Chistmas disease, is caused by a lack of the blood clotting factor IX.

Von Willebrand Disease (VWD) is the most common hereditary bleeding disorder, affecting as many as 3 million people in the United States (approximately 1% of the population).  This disorder is due to a lack of Von Willebrand factor, which helps platelets stick together—and to the blood vessel wall at the site of injury—to form a clot.  There are two main types:

1. Von Willebrand disease type I is due to a low level of Von Willebrand factor in the blood.
2. Von Willebrand disease type II is due to a defect in the Von Willebrand factor (protein) itself.

Treatment While there is no cure for bleeding disorders, these conditions can be successfully managed.  A hematologist (a physician with special training in blood disorders) handles a bleeding disorder patient’s care and identifies the best treatment options.