Overview
Coagulation disorders (coagulopathies) describe conditions characterised by reduced clotting of the blood, abnormal platelet function or synthesis, or blood vessel walls that lead to increased bleeding. This section covers some of the causes of coagulation disorders.
Classification
Congenital bleeding disorders
- Von Willebrand disease (vWD) – autosomal dominant and most common
- Due to dysfunction or deficiency of von Willebrand factor (vWF)
- Haemophilia A (factor VIII deficiency) or B (factor IX deficiency) – x-linked recessive
Acquired bleeding disorders
- Liver disease and cirrhosis:
- Due to reduced clotting factor synthesis and thrombocytopenia
- Vitamin K deficiency – needed for factors II, VII, IX, X, protein C, and protein S
- May be due to dietary insufficiency, malabsorption, or vitamin K deficiency in the newborn
- Disseminated intravascular coagulopathy (DIC)
- Usually seen in states of haemodynamic instability e.g. sepsis/malignancy
- Renal disease
- Due to dysfunction/reduced aggregation of platelets
- Autoimmune conditions:
- Systemic lupus erythematosus
- Immune thrombocytopenic purpura
- Vitamin C deficiency
- Due to defective collagen synthesis and capillary fragility, making them more likely to bleed, and poor wound healing
