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We can observe a group of hemorrhagic diatheses in which the cause of excessive haemorrhage is not a defect or low number of platelets, or a congenital or acquired deficiency of plasma coagulation elements, but the dysfunction or leakage of vascular endothelium. It promotes the penetration of blood cells into the environment through the vessel wall, despite the efficiency of other components of the blood clotting process.
General classification of vascular bleeding disorders
Before the physician makes the final diagnosis of vascular bleeding disorders, he should exclude its plasma or platelet nature.
Among the vascular bleeding disorders we can distinguish:
- congenital vascular bleeding disorders,
- acquired vascular hemorrhagic diathesis.
Congenital bleeding defects
Types of congenital vascular bleeding disorders
Among congenital vascular bleeding disorders we can distinguish:
- Congenital haemorrhagic angioma (also called Rendu-Osler-Weber disease or syndrome),
- Ehlers-Danlos syndrome,
- Marfan syndrome,
- other.
The common feature of these diseases is congenital damage to the vessel wall, which contributes to the penetration of blood cells beyond the vascular bed.
Symptoms of congenital vascular hemorrhagic diathesis
The symptoms of congenital hemorrhagic diathesis (as the most common) include:
- prolonged bleeding from the nose or mouth that likes to come back,
- haematuria and bleeding from the stomach and intestines.
In addition, the skin and mucous membranes may be associated with dilatation of capillaries and arterioles (Rendu-Osler-Weber syndrome) or generalized congenital laxity of connective tissue (Ehlers-Danlos syndrome).
Vascular hemorrhagic diathesis – diagnosis
These diseases are relatively rare. Establishing a final and correct diagnosis requires a medical examination and laboratory diagnostics to exclude platelet and plasma hemorrhagic defects.
Treatment of congenital vascular bleeding disorders
Treatment of congenital vascular bleeding disorders is recommended only in the event of major bleeding or haemorrhage. What should home treatment look like? If bleeding occurs, the procedure is the same as for any other haemorrhage:
• apply a cold compress,
• a pressure dressing is required.
If there are difficulties in controlling the bleeding, the patient should be transported as soon as possible to the emergency room or hospital outpatient clinic. Often, too long waiting for an ambulance unnecessarily extends the time of reaching specialist help. Rarely, however, the bleeding is intense, profuse and prolonged.
Symptomatic hematopoietic treatment is recommended in the event of secondary anemia and iron deficiency.
How to prevent congenital vascular bleeding disorders?
Preventive measures for congenital bleeding disorders include:
- avoiding too much physical exertion,
- preventing body injuries,
- systematic intake of blood vessel strengthening agents,
- eating homemade preserves containing vitamins (especially vitamin C), e.g. vegetable and fruit products.
ACQUIRED BLOOD BLADES
What causes acquired vascular hemorrhagic diathesis?
The reason for the occurrence of acquired vascular bleeding is the acquired, usually disseminated, damage to the vascular wall, which allows blood cells to penetrate beyond the vessel wall, and thus the formation of more or less numerous ecchymoses.
The factors contributing to the acquired hemorrhagic diathesis include:
- infectious-toxic (e.g. in measles, diphtheria, scarlet fever, chicken pox, chronic endocarditis),
- allergic-toxic stimuli (e.g. when using various preparations, usually accompanying rheumatic disease, Schönlein and Henoch hemorrhagic diathesis),
- disorders in metabolism, hormonal factors and avitaminosis (e.g. vitamin C deficiency, Cushing’s disease),
- increased vascular fragility (e.g. vascular hemorrhagic diathesis, after mechanical injuries or in the event of impaired blood outflow due to pressure over a long period of time), edema in the course of heart failure or after prolonged standing).
Treatment of the acquired hemorrhagic diathesis
Treatment of the acquired hemorrhagic diathesis depends on the cause that caused the hemorrhagic symptoms of vascular wall damage. Treatment should be directed at treating the underlying disease. Symptomatic treatment to strengthen damaged blood vessels should also be considered.
Prevention of acquired vascular hemorrhagic diathesis
The prevention of acquired haemorrhagic diathesis consists primarily in preventing the occurrence of pathological ailments promoting toxic damage to the vascular endothelium and lack of vitamins (especially vitamin C and routine) and preventing excessive blood pressure on the vessel walls, e.g. stagnation, hypertension.
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