2009-11-03 17:34:17 - Coagulation Disorders

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The process of coagulation is a complex interaction between cellular elements of the blood and many blood borne proteins. Adherence of the cellular elements, the platelets, to damaged tissues triggers primary hemostasis. Secondary hemostasis occurs when the clotting proteins interact to form a blood clot. Both of these processes are interrelated and obligatory to prevent blood loss.
Congenital forms of bleeding

disorders are uncommon. Acquired disorders are more frequent, and arise from insufficient amounts of coagulation proteins, or proteins that do not function normally. These disorders affect primary and secondary hemostasis.
The most common forms of acquired bleeding disorders are disseminated intravascular coagulation, liver disease, vitamin K deficiency and the use of anticoagulation therapy.

Causes of Coagulation Disorders


There are numerous congenital causes of coagulation disorders. These diseases exert their effect by either limiting the amount of clotting factors present, or by producing clotting factors that do not function normally. These diseases include hemophilia and rarer causes of various clotting factor deficiencies.
DIC is caused by the liberation of certain cellular components in extensive injuries and burns. All types of infections have been known to lead to DIC, including bacterial, fungal, viral and parasitic. Cancer can lead to the development of DIC.
When the liver is damaged by any disease process, it can lead to inadequate production of clotting factors. Administration of certain medications may interfere or block the cascade of clotting proteins. The most common drug to do this is coumadin.

Signs and Symptoms of Coagulation Disorders


All these abnormalities can lead to excessive bleeding with trauma or surgery. In women, increased menstrual bleeding can occur. Congenital deficiencies, such as hemophilia, can lead to bleeding within the joints. This can eventually lead to fibrosis and arthritis of the joint, with impaired function. Bleeding can occur in vital organ with minor trauma, such as the brain. Blood in the urine can come from injuries or trauma to the urogenital tract.
DIC is a severe, generalized bleeding disorder. It frequently arises in acutely ill patients. Extensive trauma, obstetrical catastrophes, systemic infections and burns all can produce this. It results is impaired systemic clotting and bleeding, often within multiple organs.

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