Consumptive coagulopathy is in a disease area that involves disorders of clotting. The clotting ability of blood is a vital property, which is disturbed to a greater or lesser extent in consumption coagulopathy.
What is consumptive coagulopathy?
Consumptive coagulopathy has this apt name because this condition is associated with a reduction in the so-called clotting factors and platelets or thrombocytes responsible for blood clotting. When an injury occurs, the clumping together of platelets (coagulation) helps a wound close quickly and allows blood that has been exposed to air to solidify. In a consumption coagulopathy, there is an increase in clotting, which is evident within the blood vessels. Additional clotting factors depleted in a consumption coagulopathy include proteins dissolved in the blood plasma or present on platelets, such as fibrinogen, proaccelerin, prothrombin, and others.
Causes
Consumptive coagulopathy usually arises in association with various preexisting conditions that lead to irregularities in the coagulation system. Because a connection to other health disorders can always be found in consumption coagulopathy, this clinical picture is not independent. Both acute and chronic consumption coagulopathy can occur as a result of liver tissue atrophy (liver cirrhosis), poisoning or so-called hemoblastosis. The liver in particular is significantly involved in the production of coagulation factors, so that a consumption coagulopathy develops when its functional capacity is impaired. Other causes of consumptive coagulopathy include shock as well as a severe form of sepsis, acute leukemia, extreme blood loss from extensive injury, acute inflammation of the pancreas (pancreatitis), and amniotic fluid embolism.
Symptoms, complaints, and signs
Symptoms of consumptive coagulopathy present as concomitants of other conditions. If they occur, they regularly refer to life-threatening complications. The high bleeding tendency entails that sufferers bleed to death internally. Skin and mucous membrane hemorrhages are typical. Externally, hematomas or bruises are visible and can occur anywhere on the body. The extremities of the toes and fingers turn bluish. It is not uncommon for additional bleeding to occur in internal organs. The kidneys, stomach and intestines are affected. In severe cases, acute liver failure occurs. In addition, nonspecific accompanying symptoms develop. In addition to fever, fainting and shortness of breath can occur as a result of the lack of oxygen supply. Circulation then regularly collapses. The list of diseases that cause consumption coagulopathy is long. Infectious patients favor it just as much as persons who have suffered a shock. The secondary disease has also been proven to occur after severe burns or heat stroke. Those whose bodies release large quantities of prothrombin activators following surgery also risk clotting disorders. Women sometimes suffer from consumptive coagulopathy during birth complications such as amniotic fluid embolism. Advanced cancer can also cause it to develop.
Diagnosis and progression
The course of consumptive coagulopathy involves three stages, which are categorized as abnormal activation of blood clotting, an absence of clotting factors, and an inability to clot. In the last stage of consumption coagulation, the factors that are uppermost in the coagulation process, as well as platelets and antithrombin, are no longer available in sufficient quantity. As a result, those affected by a consumptive coagulopathy go into shock, causing multiorgan failure. In contrast, a consumption coagulopathy can cause people to bleed to death because the so-called bleeding tendency is extremely high. The specific disease symptoms are crucial for the diagnosis of consumption coagulopathy. These are supported by laboratory tests (quantitative determination of platelets, coagulation tests with blood plasma).
Complications
In consumptive coagulopathy, affected individuals usually suffer from a severe blood clotting disorder. In this case, the blood takes a relatively long time to clot, so bleeding cannot be stopped easily. Even very minor injuries or cuts can result in severe bleeding, which in the worst case can lead to bleeding to death of the affected person. Furthermore, skin bleeding frequently occurs, so that those affected also suffer from aesthetic discomfort. Many patients feel uncomfortable with this and also suffer from inferiority complexes or significantly lowered self-esteem. Consumptive coagulopathy can cause the skin to turn blue, as the internal organs are no longer supplied with sufficient oxygen. Bleeding from the internal organs themselves is also not uncommon and can severely damage the respective organs. Patients must inform their doctors about consumption coagulopathy in good time, especially during surgical procedures. Treatment of consumptive coagulopathy usually only needs to be given when bleeding actually occurs. In this case, those affected are dependent on taking medication. Further complications do not usually occur.
When should you go to the doctor?
Since consumption coagulopathy cannot heal on its own, the affected person should always consult a doctor when suffering from this disease. This is the only way to prevent further complications or discomfort, so a doctor should be contacted at the first symptoms or signs of the disease. An early diagnosis always has a positive effect on the further course of this disease. A doctor should be consulted for consumption coagulopathy if the affected person suffers from bruises all over the body. These bruises occur without any particular reason and usually do not disappear on their own. Likewise, the disease causes high fever and further also liver failure, so that these complaints can also indicate the consumption coagulopathy. Especially after a heat stroke or after a severe burn, these symptoms can occur and should be examined by a physician. The initial examination can be performed by a general practitioner. Further treatment usually requires a visit to a specialist. It cannot be generally predicted whether there will be a reduced life expectancy as a result of the condition.
Treatment and therapy
Typically, consumptive coagulopathy is always associated with a severe depletion of blood volume as a sequela of another disease or surgical procedure, as well as an accident. For this reason, a tangible therapy for consumption coagulopathy is not always easy to implement. In the therapy of a consumption coagulopathy, the treatment of the causative disease is first and foremost in the foreground. In particular, the treatments of consumption coagulopathy are based on achieving effects that reduce the risks of consumption coagulopathy. In this regard, it is obvious to first “replenish” the lost coagulation factors including platelets. Special platelet concentrates are available for this purpose, which can be administered by infusion. For these life-threatening emergencies, blood establishments and clinics keep on hand so-called fresh-frozen plasma, which can be quickly thawed and infused. This plasma is not only enriched with platelets, but also contains large concentrations of clotting factors to prevent consumption coagulopathy. Treatment of a consumption coagulopathy requires permanent medical monitoring and is therefore performed in intensive care units. If a consumption coagulopathy was found to have thrombocytopenia (platelet count below normal) and platelet dysfunction, therapy with desmopressin was given. If consumption coagulopathy occurs as a result of coumarin poisoning, vitamin K is given.
Prevention
It is difficult to prevent a disorder of blood coagulation, which can cause consumptive coagulopathy. People who suffer from the symptoms presented should establish as healthy a lifestyle as possible and have their coagulation levels checked regularly.In addition, patients with classic diseases that give rise to consumptive coagulopathy live at increased risk, which must be taken seriously.
Follow-up
Depending on the severity of the disease, individuals are always at risk for sudden unstoppable bleeding. Internal injuries may cause severe impairment to those affected. Sufferers should urgently undergo withdrawal from alcohol, otherwise serious complications and rapid worsening of the disease may occur. Affected persons should always maintain contact with family and friends and inform them sufficiently about the disease. In emergencies, family members can then act immediately. Also, in other situations where sufferers need help, they can then ask for it from relatives. For this reason, they should always carry an ID card with them that lists which medications they are taking. In an emergency, doctors can then take the right action immediately. The diet should be very balanced and rich in vitamins, and sufficient exercise is also supportive of recovery. It is important that those affected learn to live with the disease. For this, long-term psychological counseling can be useful. A self-help group would also be recommended. There, those affected can exchange ideas with other sufferers and find other ways of living with the disease.
What you can do yourself
Adaptations in everyday life to consumption coagulopathy depend on the extent to which the disease is present. In this case, there is basically always a risk of bleeding that is difficult to stop. This can lead to serious complications in patients in the event of internal injuries. If the consumption coagulopathy is hereditary, causal treatment is not possible. If the reduced coagulability of the blood is due to the use of certain medications or even alcohol abuse, alternative treatment methods or, in some cases, alcohol withdrawal should be considered. In the case of artificially induced blood thinning due to the intake of so-called coagulation inhibitors, increased attention is necessary in order to avoid any injuries as far as possible due to the increased risk of bleeding. It is also recommended that patients carry a special identification card stating that they are taking anti-coagulant medication. If the consumption coagulopathy is due to a disease, such as sepsis, the causative pathogens should be treated and eliminated as a matter of urgency. If this is not done, serious complications can occur, especially acute kidney failure. Patients can also improve their symptoms by incorporating sports activities into their daily routine. In addition, a healthy diet is important for sufferers because it helps prevent mineral and vitamin deficiencies.
