Acquired Bleeding

Acquired bleeding is not inherited, or passed through families, like most bleeding disorders. Several medical conditions may trigger interaction with or formation of antibodies against either coagulation factor. The antibodies inactivate the coagulation factor, and bleeding symptoms may occur. Acquired bleeding disorders affect men and women equally, and the potential for significant bleeding problems is high.

Potential Causes of Acquired Bleeding

Another, much more common cause of acquired bleeding is the impact of certain drugs that suppress the production of coagulation factors, such as coumarin derivates like warfarin. Patients that receive these drugs have reduced concentrations of coagulation factors II, VII, IX and X. Overdosing of warfarin or surgical intervention in these patients can lead to life-threatening bleeding conditions. Therefore, such patients require tight monitoring of their coagulation status in order to avoid bleeding. Before surgery, these patients need anticoagulant reversal using coagulation factor concentrates.

Accidents and surgical interventions in general can also lead to massive blood loss and subsequently to a critical reduction in coagulation factors. In addition to bleeding caused by the injury or the surgical intervention itself (surgical bleeding), the critical reduction in the level of coagulation factors can lead to additional non-surgical bleeding complications that can be difficult to control (e.g., coagulopathic bleeding). Such patients can have critically low concentrations of basically all coagulation factors. In general, it is necessary to replace coagulation factors with allogenic blood products or coagulation factor concentrates in order to reverse the critical condition.

Acquired bleeding symptoms include:

• Internal bleeding
• Bleeding into the skin and soft tissues

Acquired von Willebrand Disease

In rare cases, von Willebrand disease (VWD) may also be acquired later in life. This is known as acquired von Willebrand syndrome (AVWS). AVWS occurs as the result of another medical condition.

Some possible causes of Acquired von Willebrand Syndrome are:

• Specific immune proteins or antibodies attack von Willebrand factor (VWF), due to an autoimmune disorder
• Disorders of blood production, also known as myeloproliferative disorders
• Certain cancers
• Damage to VWF from abnormal heart valves or other heart defects
• Thyroid disease
• A range of pharmaceuticals, including valproic acid

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