Original Articles
Vol. 8 (2016): Review, Original Articles, Case Reports
https://doi.org/10.4084/mjhid.2016.049

MILD BLEEDERS: DIAGNOSIS IS ELUSIVE IN LARGE NUMBER OF PATIENTS

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Received: March 4, 2016
Accepted: September 12, 2016
Published: October 17, 2016
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Mild Bleeders, VWD, Platelet function defects, Hemophilia, Diagnosis
Hematology

Authors

Mrinalini kotru
Senior resident,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029, India.
Deepti Mutereja
Senior resident,Department of Hematology, AIIMS, Ansari Nagar, , Delhi, India-110029, .
Abhishek Purohit
Senior resident,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029, .
Seema Tyagi
Associate Professor,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029, .
Manoranjan Mahapatra
Professor,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029, .
Renu Saxena
Professor and Head,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029, .
Hara Prasad Pati
harappati@yahoo.co.in
Professor,Department of Hematology, AIIMS., .

Abstract. Background: Bleeding is a common clinical presentation. Even patients with mild bleeding disorders are extensively investigated for ascertaining the cause. The present study was conducted in order to evaluate the extent of the possibility of diagnosis in mild bleeding disorders.

Material and Methods: This was a prospective study of patients referred for work up of mild bleeding for a period of 13 months. A complete blood count, peripheral smear examination, Prothrombin time, Partial Thromboplastin time and Thrombin Time, Platelet Aggregometry test, tests for von Willebrand’s disease and Platelet function 3 availability were measured.

Results: 164 patients presented with mild bleeding, in 114 of the  patients a single site of bleeding was present. Epistaxis was the most common presentation (39%). Cutaneous bleeding (petechiae and purpura) was the next common site. History of a major bleeding tendency in the family was present only in 11 patients. The investigations showed that VWD (17/164), followed by clotting disorders (CD) mainly mild hemophilia (15/164) were the most common diagnosable cause. There were also 4 cases of hypofibrinogenemia. The disorders of platelets (Platelet function defects/PFD) were the least common (9/164). Rest 123 (75%) patients could not be diagnosed on the basis of these investigations and were labeled as  Bleeding disorders – Unclassified (BDC).

Conclusion: n our study, 75% of the patients with mild bleeding remained undiagnosed even after extensive laboratory workup, thus raising a very pertinent question that is it necessary that all mild bleeders submit to a broad battery of investigations, as the diagnosis continues to be elusive despite extensive workup.

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original articles

Supporting Agencies

nil
Mrinalini kotru, Senior resident,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029
Senior resident , hematology ,AIIMS
Deepti Mutereja, Senior resident,Department of Hematology, AIIMS, Ansari Nagar, , Delhi, India-110029
Senior resident,Department of Hematology,

Abhishek Purohit, Senior resident,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029
Senior resident,Department of Hematology,
AIIMS
Seema Tyagi, Associate Professor,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029
Associate Professor,Department of Hematology,
AIIMS.
Manoranjan Mahapatra, Professor,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029
Professor,Department of Hematology,
AIIMS
Renu Saxena, Professor and Head,Department of Hematology, AIIMS, Ansari Nagar, Delhi, India-110029
Professor and Head,Department of Hematology,
AIIMS.
Hara Prasad Pati, Professor,Department of Hematology, AIIMS.
Professor,Department of Hematology,

How to Cite



“MILD BLEEDERS: DIAGNOSIS IS ELUSIVE IN LARGE NUMBER OF PATIENTS” (2016) Mediterranean Journal of Hematology and Infectious Diseases, 8, p. e2016049. doi:10.4084/mjhid.2016.049.