A blood clot is a process in which blood coagulates from a liquid converts into a gel or semi-solid state. Blood clots are necessary because they prevent the body from losing too much blood, as in the event of an injury or cut. In other words, bleeding disorders cause a person to bleed excessively for various reasons.
When bleeding occurs, the body reacts by using platelets and proteins located within the blood to travel to the bleeding site. The platelets and proteins then begin to solidify to prevent further bleeding. They act as a sort of plug that blocks blood from exiting the injury site. Bleeding disorders complicate the blood clotting process, thus causing someone to bleed more than usual when injured. Over three million Americans live with bleeding disorders, with some being more common than others.
Most bleeding disorders come from genetics, meaning they pass down from generation to generation. While there are many types of bleeding disorders, there are three in particular that are the most common.
Classic hemophilia (hemophilia A) is a common genetic disorder. With hemophilia A, there is a lack or absence of the factor VIII clotting protein. In most cases, children inherit this bleeding disorder from their parents. However, it is not unusual for the condition to develop after a spontaneous genetic mutation. Hemophilia A affects 20,000 people in the United States.
Those with hemophilia A will bleed more than those who do not have the bleeding disorder. The severity of symptoms ranges from mild to severe. These bleeds not only occur externally but can occur internally as well, often in muscle tissue and bone joints. The factor VIII clotting protein develops naturally within the blood. Typically, these protein levels range from 50% to 150%. Individuals with factor VIII levels that fall below 50% will determine the severity of the symptoms related to hemophilia A.
In mild cases of hemophilia A, excessive bleeding mostly occurs only after a severe injury, intense trauma, or during major surgery. In more extreme cases, however, an individual has less than 1% of factor VIII protein levels. With factor VIII levels that low, bleeding may occur spontaneously and into muscle tissue and bone joints. Hemophilia A is a treatable condition, and doctors regularly inject concentrated versions of the factor VIII protein to create a balance in the bloodstream and aid in clotting.
Christmas disease, or hemophilia B, is a bleeding disorder in which there is an absence or a reduced amount of factor IX protein in the blood. Factor IX protein is a plasma protein that is vitamin K dependent. The condition has nothing to do with the Christmas holiday. Stephen Christmas was the first person diagnosed with the disease in 1952, hence the nickname ‘Christmas disease.’
Although not as common as hemophilia A, Christmas disease is a bleeding disorder that also hinders the ability of blood to clot properly. This form of hemophilia causes random, prolonged bleeding episodes. If not treated, hemophilia B can be fatal.
Symptoms of Christmas disease include excessive bleeding from injury or small cuts, excessive bruising, prolonged nosebleeds, painful joints caused by internal bleeding, and unexplained blood in urine or stool. Although there is no cure for hemophilia B, doctors can provide treatment to minimize the symptoms.
To encourage proper clotting, doctors typically recommend factor XI protein injections. The injections can either come from a human blood sample or a medically developed version of the protein. Blood-derived factor XI is not as safe as the lab-created version, so doctors prefer to use the latter. Doctors may also offer a topical product called desmopressin acetate. Applying the product to an exposed wound serves as a coagulant aid, which encourages clotting.
Similar to hemophilia A, Von Willebrand disease is another bleeding disorder inherited through genetics. Just as with hemophilia A, a person with VW disease lacks the factor VIII protein that aids in clotting. The difference is that, with VW disease, the condition is much milder. Patients may not even notice symptoms. VW disease is a lifelong disease that has no cure. Treatment for Von Willebrand disease is similar to that of hemophilia A, as are the symptoms.
Bleeding disorders rarely make life unbearable. With the right treatment, people with bleeding disorders can live healthy life.
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