1st order laboratory parameters – obligatory laboratory tests.
- Small blood count [thrombocytopenia?]
- Differential blood count
- Coagulation parameters – bleeding time, PTT, Quick or INR.
- Determination of coagulation factors:
- VIII (hemophilia A),
- IX (hemophilia B),
- VWF (von Willebrand factor; synonyms: Clotting factor VIII-associated antigen or von Willebrand factor antigen, vWF-Ag).
- If necessary, other coagulation factors
Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification.
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
Other notes
- If the above examinations reveal only normal findings, the following diseases should be considered:
- Schönlein-Henoch purpura [new: IgA vasculitis (IgAV)]; palpable petechiae/palpable purpura; multitude of pinhead-sized hemorrhages from capillaries into the skin or mucous membranes; preferred region: legs and buttocks.
- Osler-Weber-Rendu disease (synonyms: Osler disease; Osler syndrome; Osler-Weber-Rendu disease; Osler-Rendu-Weber disease; hereditary hemorrhagic telangiectasia, HHT) – autosomal-dominant inherited disorder in which telangiectasia (abnormal dilation of blood vessels) occurs. These can occur anywhere, but are found especially in the nose (leading symptom: epistaxis (nosebleed)), mouth, face, and the mucous membranes of the gastrointestinal tract. Because the telangiectasias are very vulnerable, it is easy to tear and thus bleeding.
- Senile purpura and steroid-induced purpura (here: skin bleeding in the area of the backs of the hands and forearm extensor sides).
