Diagnosis of mild bleeding disorders

The precise diagnosis of a severe haemorrhagic disorder is usually not too problematic. However, physicians are most often faced with individuals consulting for mild haemorrhagic symptoms, particularly occurring after a surgical intervention. The problem here is to evaluate whether this person really has a bleeding disorder requiring special investigations and treatments, particularly if another invasive procedure is planned. The key point is to ask the appropriate questions to discriminate bleeding occurring in normal subjects from that occurring in patients with haemostatic disorders. Recently, bleeding questionnaires allowing the calculation of bleeding scores have been proposed. Although they have some limitations, they are of help to better define and quantify the bleeding symptoms and to guide in the choice of selecting laboratory testing. This review focuses on inherited and not on acquired bleeding disorders.