Unlike most bleeding disorders, acquired bleeding disorders are not inherited or passed through families. Acquired bleeding disorders can spontaneously occur, but most have an identifiable root cause. Men and women are equally likely to be affected by an acquired bleeding disorder, and the potential for problems is high.
Acquired bleeding symptoms include:
- Internal bleeding
- Bleeding into the skin and soft tissues
Potential Causes of Acquired Bleeding
One cause of acquired bleeding disorder is formation of antibodies against the coagulation factor, often triggered by a patient’s medical condition. The antibodies can inactivate the coagulation factor, and bleeding symptoms may occur.
A much more common cause of acquired bleeding, however, is the impact of certain drugs that suppress the production of coagulation factors, such as coumarin derivatives like warfarin. Patients who receive these drugs have reduced concentrations of coagulation factors II, VII, IX and X, and thus require tight monitoring of their coagulation status. Overdosing of warfarin or surgical intervention in these patients can lead to life-threatening bleeding conditions. Before surgery, these patients need anticoagulant reversal in order to restore normal coagulation.
Perioperative Bleeding & Bleeding in Critically Ill Patients
Accidental injuries and surgical interventions in general can also lead to massive blood loss resulting in a critical reduction in the level of coagulation factors which can lead to additional non-surgical bleeding complications (e.g., coagulopathic bleeding). Patients with this type of difficult-to-control bleeding can have critically low concentrations of 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 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
11/12/2013 5:38 PM