Read Microsoft PowerPoint - Spectrum of bleeding disorders Experience at Armed Forces Institute of Pathology Rawalpindidr shawana [C text version

Spectrum of bleeding disorders: Experience at Armed Forces p Institute of Pathology Rawalpindi

Shawana Kamran, Suhaib Ahmed, Kamran Nazir Ahmad, Jaleel Anwar ,

Components of hemostasis

Phases of hemostasis

·Tethering Tethering


·Thrombus formation Th b f ti and stabilization

Interaction among various hemostatic components

Clinical features of hemostatic defects


Onset of bleeding

Coagulation Platelet/vessel defect defect

Delayed after trauma Rare Rare Characteristic Large and solitary Characteristic Spontaneous or immediately after trauma Common Characteristic Rare Small and multiple Rare Persistent, often profuse Equal

Mucosal bleeding Petechiae Deep hematomas Ecchymoses Hemarthrosis

Bleeding from Minimal superficial cuts and scratches Sex of patient 80-90% male

Clinical features of platelets/vessel defects d f t

Clinical features of coagulation protein defects

Objective Obj ti

To determine the frequency of bleeding disorders diagnosed at Armed Forces Institute of Pathology Rawalpindi Pathology,

Study d i St d design

Descriptive study

Setting d duration S tti and d ti

Department of Hematology Armed Forces Institute of Pathology Rawalpindi from January 2005 to June 2008

Subjects d S bj t and sampling t h i li technique

A total of 1823 patients of bleeding diathesis sent for coagulation profile were included in the study Non probability purposive sampling

Materials d M t i l and methods th d

Hess s Hess's test was done to investigate the vascular defects. Bleeding Time was done to test platelet function defects. The `clotting screen' and mixing studies clotting screen were done to detect coagulation protein defects. Clot solubility test was also performed for factor XIII deficiency.

Tests for platelet/vessel defects

· Bleeding Time by Ivy's Method · Hess's test

Clotting screen


Frequency of bleeding disorders


Coagulation protein C l ti t i defect

18.6% 18 6%


62.8% 62 8%

von Willebrand factor deficiency platelet function defects


Frequency of coagulation protein defects


factor VIII factor XI factor V

1.1% 2.9% 3.3% 4.4% 5.5% 6.6% 6 6% 11.7%


factor XIII factor VII factor X factor I factor II Multiple factor p

Conclusion C l i

Coagulation protein defects are the most frequent bleeding disorders with Factor VIII deficiency being the commonest. Platelet function defects and vWF deficiency also comprise a significant proportion of the bleeding disorders.


Microsoft PowerPoint - Spectrum of bleeding disorders Experience at Armed Forces Institute of Pathology Rawalpindidr shawana [C

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