MILD BLEEDERS: DIAGNOSIS IS ELUSIVE IN LARGE NUMBER OF PATIENTS

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Mrinalini kotru
Deepti Mutereja
Abhishek Purohit
Seema Tyagi
Manoranjan Mahapatra
Renu Saxena
Hara Prasad Pati *
(*) Corresponding Author:
Hara Prasad Pati | harappati@yahoo.co.in

Abstract

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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Article Details

Author Biographies

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,

References

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