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Laboratory issues in bleeding disorders.

D Lillicrap1, S C Nair, A Srivastava

  • 1Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.

Haemophilia : the Official Journal of the World Federation of Hemophilia
|May 11, 2006
PubMed
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Accurate diagnosis of bleeding disorders relies on clinical history and bleeding scores. Laboratory tests are crucial for identifying specific hemostasis defects, especially for von Willebrand

Area of Science:

  • Hematology
  • Clinical Diagnostics

Background:

  • Clinical history and family evaluation are paramount for diagnosing inherited and acquired bleeding disorders.
  • Quantifying bleeding tendency using validated bleeding scores aids in diagnosing conditions like von Willebrand's disease (VWD).
  • VWD is the most common inherited bleeding disorder, yet underdiagnosis remains prevalent, particularly in developing nations.

Purpose of the Study:

  • To emphasize the importance of clinical history and bleeding scores in diagnosing bleeding disorders.
  • To outline a systematic laboratory approach for identifying specific hemostasis defects.
  • To highlight the critical need for prompt diagnosis of rare but life-threatening acquired inhibitors of hemostasis.

Main Methods:

  • Utilizing detailed patient and family clinical history.

Related Experiment Videos

  • Employing specific questionnaires and bleeding scores to assess bleeding tendency.
  • Implementing a tiered laboratory diagnostic strategy: initial screening followed by focused second-level testing.

    • Main Results:

    • Careful evaluation of bleeding history via a bleeding score guides subsequent laboratory investigations.
    • A structured laboratory approach effectively identifies the abnormal phase of hemostasis involved.
    • Prompt characterization of acquired inhibitors is essential due to their potential to be life-threatening.

    Conclusions:

    • Clinical assessment, including bleeding scores, is the cornerstone of diagnosing bleeding disorders.
    • A stepwise laboratory approach is necessary to pinpoint specific hemostatic defects.
    • Timely diagnosis and management of acquired inhibitors are critical for patient survival.