Symptoms of coagulation disorders

Coagulation dysfunction is a relatively common disease manifestation. At present, it is mainly divided into acquired and hereditary types. It is usually caused by the deficiency of a single coagulation factor, leading to bleeding symptoms in infants and young children. It has an important relationship with heredity. Acquired coagulation dysfunction is also relatively common in clinical practice. It is often caused by the deficiency of multiple coagulation factors. For example, hemophilia is a relatively common coagulation dysfunction.

The main clinical manifestation of hemophilia is bleeding, characterized by bleeding in soft tissues, muscles, and weight-bearing joints. Bleeding tendency usually occurs in early childhood, and mild cases may not be diagnosed until adolescence or even adulthood. The earlier the bleeding symptoms appear, the more serious the condition. Patients may present with severe bleeding after minor trauma or surgery, often with bleeding that does not stop during tooth extraction or minor surgery.

A small number of patients experience this as the first symptom. Bleeding can continue for hours or even weeks. The degree of bleeding is related to the plasma factor activity (concentration). Although the activity of factor VII or IX required for normal hemostasis is 25%, the factor activity in symptomatic patients is often less than 5%. Clinically, hemophilia is divided into severe, moderate, mild and subclinical types based on factor activity.

The most common sites of bleeding are the vulnerable parts of the limbs. Deep tissue hematomas may occur. Large hematomas may compress nearby nerves such as the femoral nerve, median nerve, and ulnar nerve, causing pain and paralysis symptoms; compression of blood vessels may cause jaundice. Bleeding from the soft tissues of the neck and throat may cause suffocation due to airway obstruction. Retroperitoneal and mesenteric bleeding may cause abdominal pain.

Severe cases may experience epistaxis, gingival bleeding, gastrointestinal bleeding, and hematuria. Excessive bleeding may cause anemia. Recurrent bleeding into the joint cavity occurs in critically ill patients, often after minor injuries, and may also occur spontaneously.

There may be local swelling, pain, tenderness, and acute symptoms lasting 3 to 5 days. After the bleeding stops, the accumulated blood will be gradually absorbed after about a few weeks and no trace will be left. If it is not absorbed over time, it can cause synovitis, and repeated bleeding can cause joint stiffness, and finally lead to permanent joint damage, osteoporosis, limited joint movement, deformation, and nearby muscle atrophy, resulting in disability. The most commonly affected joints are the ankles in infants and young children and the knees in children and adults.

Clinical manifestations of vitamin K deficiency

Clinical manifestations include skin petechiae, ecchymoses, and mucosal bleeding, which are generally mild. In addition, trauma, postoperative bleeding, hematuria, menorrhagia and gastrointestinal bleeding also often occur. No deep tissue bleeding or joint bleeding was observed.