Hemorrhagic diathesis appear in parts of the system (such as the defeat of the vascular wall) and arise as increased bleeding as in adults and children. Hemorrhagic disease is bleeding of the mucous membranes. You can detect it by passing a full blood count.
What is hemorrhage
In medicine, spontaneous outflow of blood from the vessels in any area of the body is called hemorrhage. This pathological syndrome manifests itself in patients in response to external stimuli or with internal diseases. Hemorrhagic disease occurs because of damage to the integrity of vessel walls, reduce the number of platelets, disorders of coagulation hemostasis. The blood follows the boundaries of the blood vessel through the damaged area. The types of anomalies depend on what part of the body they manifest.
Hemorrhagic syndrome characteristic of what disease
Among the forms of hemorrhagic diseases distinguish inherited and acquired disorders of hemostasis. The latter are associated with multifactorial disorders of blood coagulation (for example, acute DIC syndrome), lesions of the blood vessels dysmetabolic, immune, toxic, infectious, immune complex origin, anomalies of the adhesive plasma proteins, damage of platelets and megakaryocytes. Hereditary hemorrhagic diseases due to:
- abnormalities of plasma factors of blood coagulation;
- disorders of hemostasis;
- genetic structural changes of the vascular wall.
Hemorrhagic diathesis in children
Due to lack of vitamin K can develop hemorrhagic syndrome of newborns, among which there are signs: hemorrhagic skin rashes, umbilical bleeding. Can happen intestinal bleeding or intracerebral hemorrhage. Doctors call the following causes of hemorrhage in newborns: during pregnancy, the mother took phenobarbital, salicylates or antibiotics. Hemorrhagic disease in children occurs when:
- neoplastic lesions of the connective tissue;
The pathogenesis of hemorrhagic syndrome
As the mechanism of development of haemorrhagic syndrome and its manifestations, the doctors describe the following picture of pathogenesis:
- a clotting disorder (DIC) and the production of platelets;
- changes in collagen structure, properties, fibrinogen, blood vessels:
- with circular disorders;
- the decrease in neurotrophic functions in the Central nervous system;
- violation angiotroficheskoy platelet function.
Hemorrhagic disease – classification
In medicine, describes such types of hemorrhagic syndromes: hematomic, petechial spotted, mixed siniakova-hematomic, vasculita purple angiomatous. These types differ in the nature of the manifestations, causes. In each case it is necessary to observe individual treatment strategy selected by the attending physician. Description of the hemorrhagic diathesis in accordance with the type of disease:
- Gematomny type due to chronic genetic bleeding disorders. This severe disease on the basis of reduced clotting is manifested in a patient with painful sensations in hemorrhages into the joints (hemarthrosis), disorders of the musculoskeletal system. Trauma, internal bruising form in the soft tissues extensive swelling, which causes pain.
- Petechial-spotted type called differently by siniakova external manifestations on the body in the form of bruises, which can be seen in the photo. Appears when bleeding disorders (deficiency of coagulation factors, and Hypo — and dysfibrinogenemia), trombotsitopaty and thrombocytopenia (thrombocytopenic purpura).
- Microcirculatory-hematomic, or mixed siniakova-hematomic bleeding develops in the presence in the blood of immune inhibitors of factors IX and VIII, overdose of thrombolytics and anticoagulants, DIC, von Willebrand disease, a severe shortage of factors of the prothrombin complex and factor XIII. On the surface, the type of disease is manifested through petechial-spotted skin hemorrhages, hematomas larger sizes in the retroperitoneal area and the wall of the intestine, petechial skin rash.
- Symptoms vasculita purple type skin rash is red (erythema). When the disease is observed the tendency to bleeding in the intestines and inflammation of the kidneys (nephritis), immune and infectious vasculitis, DIC-syndrome.
- Angiomatous type develops in the region of arteriovenous shunts, angiomas, telangiectasias. For this type of disease is characterized by hemorrhages in the area of vascular anomalies and persistent bleeding permanent localization.
Causes of hemorrhagic syndrome
May develop hemorrhagic symptoms in vascular anomalies, disorders of coagulation hemostasis, the activity of enzymes of the blood coagulation system, while taking drugs, in violation of platelet aggregation. Experts were able to establish a variety of diseases in which the risk of occurrence of hemorrhage:
- severe viral infections;
- cirrhosis of the liver;
- lack of prothrombin in the blood;
The causes of hemorrhage depend on the primary or secondary forms of the disease. For the first characterized by the presence of genetic determination: in the body there is a defective gene, which is able at any time to cause hemorrhagic disease. The secondary form is caused from damage of the vessel wall (or autoimmune process, mechanical damage, inflammation and chemical toxicity), secondary thrombocytopenia, DIC, hemorrhagic vasculitis and deficit factors protrombinovogo complex.
Symptoms of hemorrhagic syndrome
There is a connection between the localization areas of hemorrhagic diathesis and clinical picture, the intensity of the manifestations, specificity of symptoms. Signs of hemorrhage in the nasal cavity manifested recurrent bleeding from telangiectasia (extension of small blood vessels). Such symptoms characteristic of hemorrhage in the lips, mouth, throat and stomach. At the age of 30 years and during puberty increases the frequency of bleeding from telangiectasias. Among other signs distinguish:
- dissecting hematoma;
- cutaneous manifestations;
- delayed bleeding;
- reduced number of platelets;
- ekhimozy surface;
- the hemarthrosis.
Treatment of hemorrhagic syndrome
The symptoms and causes of a patient depends on the treatment of hemorrhage. In the complex therapy involved: IVIG, plasmapheresis, corticosteroids. When inflammation of the blood vessels (vasculitis) take non-hormonal immunosuppressants, nonsteroidal anti-inflammatory drugs (NSAIDs), therapy corticosteroids (glucocorticoid), and try to reduce the symptoms of inflammation. When injected hemophilia A missing factor VIII, while hemophilia B – XI. After detailed analysis of blood, the doctor helps the patient to choose the treatment tactics.
Among the fundamental principles of therapy are:
- symptomatic treatment;
- intravenous injection of a synthetic analogue of vitamin K – vikasol, calcium chloride and ascorbic acid;
- if necessary, carry out the transfusion of blood components (platelets, Packed red blood cells) and plasma;
- medications, which help strengthen the walls of blood vessels (etamzilata);
- in the local treatment of hemorrhages are shown: dry thrombin homeostatic sponge, aminocaproic acid.
The effects of hemorrhagic disease
Upon detection of hemorrhage not panic and should immediately consult a doctor. Mild disease and timely treatment prognosis is favorable. However, there are cases when later detection of the disease develop serious complications of hemorrhagic syndrome, which can lead to death.
Among these effects are: massive internal bleeding, brain hemorrhage, heart disorder, adrenal insufficiency. The child may experience hypovolemic shock, which is manifested through reduction of blood pressure and body temperature, weakness, pallor. To prevent the described consequences it is necessary as soon as symptoms are noticed, take the child for a consultation with a pediatrician.
Prevention of hemorrhagic syndrome
The following simple preventive measures can protect against the development of pathologies. To identify hemorrhagic bleeding help blood and reduce the risk of its occurrence is possible if:
- within half an hour after birth to put the baby to the breast;
- using injections to introduce vitamin a To children at risk;
- carry out the injection of vitamin K for parenteral (intravenous) nutrition;
- to perform the introduction of intramuscular vitamin K at birth, or before them if the mother takes drugs antidoron.