Blood, hematopoietic organs-immune system (D50-D90).
- Bleeding tendency (uremic) – bleeding time prolonged by uremia (occurrence of urinary substances in the blood above normal values).
- Coagulation defects:
- Disseminated Intravascular Coagulation (DIC) – acquired life-threatening condition in which clotting factors are depleted in the vasculature due to excessive blood clotting, resulting in a bleeding tendency.
- Liver failure
- Hemophilia A, B
- Willebrand-Jürgens syndrome
- Vitamin K deficiency
- Bleeding tendency due to factor deficiency, unspecified
- Purpura, senile – in old age occurring small-spotted capillary bleeding in the skin on light-exposed body parts (back of the hand and forearm).
- Schönlein-Henoch purpura [new: IgA vasculitis (IgAV)] (synonyms: Anaphylactoid purpura; Acute infantile hemorrhagic edema; Schönlein-Henoch disease; Purpura anaphylactoides; Purpura anaphylactoides; Purpura Schönlein-Henoch (PSH); Seidlmayer cocard purpura; Schönlein-Henoch purpura; Vasculitis allergica; D69. 0) – immunologically mediated vasculitis (vascular inflammation) of the capillaries and pre-capillary and post-capillary vessels, which usually runs without complications; as a multisystem disease, it preferentially affects the skin, joints, intestines and kidneys.
- Scurvy
- Thrombocytopenia (platelets < 150,000/μl):
- Synthesis disorders – aplastic disorders: Fanconi syndrome; bone marrow damage (chemicals – eg, benzene -, infections (eg, HIV); cytostatic therapy, radiation therapy).
- Bone marrow infiltrations (leukemias/blood cancers, lymphomas, bone marrow metastases).
- Maturation disorders (e.g. megaloblastic anemia/pernicious anemia).
- Increased peripheral turnover of platelets (thrombocytes).
- Disseminated intravascular coagulation; disseminated intravascular coagulation (DIC syndrome, for short; consumption coagulopathy).
- Idiopathic thrombocytopenic purpura (ITP; Werlhof’s disease) – autoantibody-mediated disorder of platelets; incidence: 1-4%.
- Hemolytic uremic syndrome (HUS) – triad of microangiopathic hemolytic anemia (MAHA; form of anemia in which erythrocytes (red blood cells) are destroyed), thrombocytopenia (abnormal reduction of platelets), and acute kidney injury (AKI); usually occurring in children in the setting of infections; most common cause of acute renal failure requiring dialysis in childhood.
- Hypersplenism – complication of splenomegaly; leads to an increase in functional capacity beyond what is necessary; as a result, there is excessive elimination of erythrocytes (red blood cells), leukocytes (white blood cells) and platelets (platelets) from the peripheral blood, resulting in pancytopenia (synonym: tricytopenia; reduction of all three cell series in the blood).
- Systemic lupus erythematosus (SLE).
- Gestational thrombocytopenia (isolated thrombocytopenia); Manifestation: II./III. Trimester / third trimester; course: asymptomatic; frequency: 75%; affects about 5-8% of all pregnancies.
- HELLP syndrome (H = hemolysis, EL = elevated liver enzymes, LP = low platelets (thrombocytopenia)) – special form of preeclampsia associated with blood count changes; frequency: 15-22 %.
- Spontaneous bleeding, unspecified drug-induced.
- Thrombotic thrombocytopenic purpura (TTP; synonym: Moschcowitz syndrome) – acute onset purpura with fever, renal insufficiency (kidney weakness; renal failure), anemia (anemia), and transient neurologic and mental disorders; occurrence largely sporadic, autosomal dominant in familial form
- Thrombocytopenia (due to medication; see below).
- Thrombocytopathy (platelet dysfunction):
- Congenital platelet defects: e.g., Glanzmann thrombasthenia, Bernard-Soulier syndrome.
- Acquired platelet defects: Liver cirrhosis, monoclonal gammopathy, myeloproliferative disorders, uremia, and by antiplatelet therapy.
- Willebrand-Jürgens syndrome (synonyms: von Willebrand-Jürgens syndrome; von Willebrand syndrome, vWS) – most common congenital disease with increased bleeding tendency; disease is predominantly transmitted autosomal-dominantly with variable penetrance, type 2 C and type 3 are inherited autosomal-recessively; there is a quantitative or qualitative defect of the von Willebrand factor; this impairs, among others. Among other things, the platelet aggregation (aggregation of platelets) and their cross-linking and / or (depending on the manifestation of the disease) the degradation of coagulation factor VIII is insufficiently inhibited.
Endocrine, nutritional and metabolic diseases (E00-E90).
- Cushing’s disease (facial plethora) – group of disorders leading to hypercortisolism (hypercortisolism; excess of cortisol).
- Wilson’s disease (copper storage disease) – autosomal recessive inherited disease in which copper metabolism in the liver is disturbed by one or more gene mutations.
Skin and subcutaneous (L00-L99).
- Nevus fuscocaeruleus: blue-green or blue-gray patchy accumulation of melanocytes expressed in varying size, shape, intensity, and localization (coccyx and buttocks); increase in size as well as intensity in the first year of life, spontaneous regression in the following years; by the age of five, 97% of the changes are no longer detectable; occurrence in central and northern European children in 1-10% of cases.
Infectious and parasitic diseases (A00-B99).
- Erythema infectiosum (ringworm).
- Rubella (German measles)
- Leishmaniasis – infectious disease caused by parasites of the genus Leishmania.
- Viral hemorrhagic fever (VHF).
Liver, gallbladder, and biliary tract-pancreas (pancreas) (K70-K77; K80-K87).
- Pancreatic insufficiency (pancreatic weakness) (due toDecreased absorption of vitamin K).
- Pancreatitis (inflammation of the pancreas).
- Portal hypertension (portal hypertension)
Neoplasms – tumor diseases (C00-D48)
- Leukemia (blood cancer
- Hodgkin’s disease – malignant neoplasm (malignant neoplasm) of the lymphatic system with possible involvement of other organs.
- Myelodysplastic syndrome (MDS) – acquired clonal disease of the bone marrow associated with a disorder of hematopoiesis (blood formation); defined by:
- Dysplastic cells in the bone marrow or ring sideroblasts or an increase of myeloblasts up to 19%.
- Cytopenias (decrease in the number of cells in the blood) in the peripheral blood count.
- Exclusion of reactive causes of these cytopenias.
One quarter of MDS patients develop acute myeloid leukemia (AML).
- Non-Hodgkin’s lymphoma – all malignant (malignant) lymphomas other than Hodgkin’s lymphoma.
Psyche – nervous system (F00-F99; G00-G99).
- Alcohol dependence
Pregnancy, childbirth and puerperium (O00-O99)
- Gestational thrombocytopenia (isolated thrombocytopenia; decreased number of platelets (thrombocytes) during pregnancy); manifestation: II/3rd trimester. Trimester; course: asymptomatic; frequency: 75%; affects about 5-8% of all pregnancies.
- HELLP syndrome (H = hemolysis, EL = elevated liver enzymes, LP = low platelets (thrombocytopenia)) – special form of preeclampsia, which is associated with blood count changes; frequency: 15-22 %.
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).
- Uremia – occurrence of urinary substances in the blood above normal levels.
Injury, poisoning, and certain other sequelae of external causes (S00-T98).
- Abuse of persons
- Trauma (injuries)
Medications that can lead to an increased bleeding tendency (A claim to completeness does not exist! ):
- Antibiotics – cephalosporins (cefriaxone, ceftazidine, cefuroxime) + oral cephaosporins.
- Anticoagulants* (heparin, tinzaparin, enoxaparin, fondaparinux, rt-PA).
- Omega-3 fatty acids (> 3 g per day).
Platelet dysfunction (A claim to completeness does not exist! ):
- Antibiotics*
- Acylaminopenicillin + ß-lactamase inhibitor (piperacillin + tazobactam, amoxicillin + clavulanic acid, ampicillin + sulbactam).
- Aminopenicillin (amoxicillin, ampicillin).
- Benzylpenicillin (penicillin G)
- Cephalosporins (cefalexin, cefazolin, cefepime, ceftazidime, ceftriaxone, ceftriazone, cefuroxime axetil, loracarbef).
- Penicillin (piperacillin + tazobactam, penicillin G, penicillin V).
- Staphylococcal penicillins (flucloxacillin).
* Simultaneous use of anticoagulants and antibiotics leads to an increased risk of bleeding! Thrombocytopenia (lack of platelets; a claim to completeness does not exist! ):
- Antiepileptic drugs (valproic acid/valproate).
- Antiprotozoal agents (pentamidine).
- Heparin + HIT II (heparin-induced thrombocytopenia) – argatroban, danaparoid, lepirudin.
- Unfractionated heparin (UFH): occurrence of HIT II in approximately 3% of cases.
- Fractionated heparin (NMH): occurrence of HIT II in approximately 0.2% of cases.
- Phosphodiesterase III inhibitors (enoximone, milrinone).
- Antiplatelet agents (TAH): clopidogrel, prasugrel, ticlopidine.
- Antivirals
- Antisense oligonucleotide (fomivirsen).
- Nucleoside analogues (cidofovir, ganciclovir, valganciclovir).
- Other (foscarnet)