Bleeding Tendency

An increased bleeding tendency (hemorrhagic diathesis; ICD-10-GM D65-D69: coagulopathies, purpura, and other hemorrhagic diatheses) may be manifested by skin, subcutaneous, or mucosal bleeding; spontaneous bleeding in, for example, joints/muscles; or abnormally heavy bleeding (e.g., menstruation, tooth extraction/removal).

The presence of spontaneous, small-spotted bleeding in the skin, subcutaneous tissue, or mucous membranes is referred to as purpura. If the individual efflorescences (pathological skin changes) of the purpura occur in spots, they are referred to as petechiae. For more information, see “Purpura and petechiae” below.

Causes of bleeding tendencies include:

  • Vascular defects
  • Platelet defects (involves the thrombocytic system; carried by platelets/platelets found in the blood)
    • Thrombocytopenias (deficiency of platelets).
    • Thrombocytopathies (dysfunction of platelets; disorders of platelet function).
  • Coagulation defects (affects the plasmatic coagulation system: 13 clotting factors).
  • Disorders of fibrinolysis (affects the fibrinolytic system; disorders of the endogenous dissolution of a thrombus (blood clot) by the enzyme plasmin).

The above causes of bleeding disorders are congenital or acquired.

Common cause of increased bleeding tendency is treatment with antithrombotic or anticoagulant drugs.

The bleeding tendency can be a symptom of many diseases (see under “Differential diagnoses”).

Course and prognosis: Course and prognosis depend on the cause of the disease. An increased bleeding tendency always requires medical evaluation.