Mixed platelet and coagulation disorders: Pathology review
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Mixed platelet and coagulation disorders: Pathology review
Pathology
Anemias
Iron deficiency anemia
Beta-thalassemia
Alpha-thalassemia
Sideroblastic anemia
Anemia of chronic disease
Lead poisoning
Hemolytic disease of the newborn
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Autoimmune hemolytic anemia
Pyruvate kinase deficiency
Paroxysmal nocturnal hemoglobinuria
Sickle cell disease (NORD)
Hereditary spherocytosis
Anemia of chronic disease
Aplastic anemia
Fanconi anemia
Megaloblastic anemia
Folate (Vitamin B9) deficiency
Vitamin B12 deficiency
Fanconi anemia
Diamond-Blackfan anemia
Heme synthesis disorders
Acute intermittent porphyria
Porphyria cutanea tarda
Lead poisoning
Coagulation disorders
Hemophilia
Vitamin K deficiency
Platelet disorders
Bernard-Soulier syndrome
Glanzmann's thrombasthenia
Hemolytic-uremic syndrome
Immune thrombocytopenic purpura
Thrombotic thrombocytopenic purpura
Mixed platelet and coagulation disorders
Von Willebrand disease
Disseminated intravascular coagulation
Heparin-induced thrombocytopenia
Thrombosis syndromes (hypercoagulability)
Antithrombin III deficiency
Factor V Leiden
Protein C deficiency
Protein S deficiency
Antiphospholipid syndrome
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
Leukemias
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Leukemoid reaction
Leukemoid reaction
Dysplastic and proliferative disorders
Myelodysplastic syndromes
Polycythemia vera (NORD)
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Essential thrombocythemia (NORD)
Langerhans cell histiocytosis
Mastocytosis (NORD)
Plasma cell dyscrasias
Multiple myeloma
Monoclonal gammopathy of undetermined significance
Waldenstrom macroglobulinemia
Hematological system pathology review
Microcytic anemia: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Extrinsic hemolytic normocytic anemia: Pathology review
Macrocytic anemia: Pathology review
Heme synthesis disorders: Pathology review
Coagulation disorders: Pathology review
Platelet disorders: Pathology review
Mixed platelet and coagulation disorders: Pathology review
Thrombosis syndromes (hypercoagulability): Pathology review
Lymphomas: Pathology review
Leukemias: Pathology review
Plasma cell disorders: Pathology review
Myeloproliferative disorders: Pathology review
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Mixed platelet and coagulation disorders: Pathology review
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Transcript
Contributors
Samantha McBundy, MFA, CMI
Robyn Hughes, MScBMC
Maria Emfietzoglou, MD
Sam Gillespie, BSc
At the emergency department, a 70 year old male named Max is admitted because of high fever with chills, and hypotension. He complains of having urinary urgency, frequency and dysuria, or painful urination, for the last few days. A few hours after admission, he rapidly deteriorates and starts to bleed from venipuncture sites. Urine and blood cultures are ordered and are both positive for gram negative rods. Lab tests show low platelet count, and bleeding time, PT and PTT are prolonged, fibrinogen is decreased and d-dimers are elevated. Peripheral blood smear shows schistocytes. Now, there’s also an 18 year old female, named Sylvia, that came in with recurrent severe nose bleeds. She also complains of heavy menstrual periods. Family history reveals her father also suffered from bleeding diathesis. Lab tests show normal platelet count, prolonged bleeding time and PTT, and normal PT.
Both Max and Sylvia are suffering from a hemostasis disorder. Hemostasis disorders, also known as bleeding disorders, can be broadly divided into three groups. The first includes problems with primary hemostasis, which is the formation of the weak platelet plug, and so, they’re referred to as platelet disorders. Now, the second group includes problems with secondary hemostasis, which is making a strong fibrin clot through activation of the intrinsic, extrinsic and common coagulation pathways, and are also known as coagulation disorders. And the last group includes disorders that affect both primary and secondary hemostasis and are known as mixed platelet and coagulation disorders. Okay, in this video, we will focus on mixed platelet and coagulation disorders, that include disseminated intravascular coagulation, or DIC, and von Willebrand disease.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Diagnosis and Treatment of Benign Bleeding Disorders" Journal of the Advanced Practitioner in Oncology (2016)
- "Bleeding and Coagulopathies in Critical Care" New England Journal of Medicine (2014)
- "Disseminated intravascular coagulation" Nature Reviews Disease Primers (2016)
- "von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA)" Haemophilia (2008)
- "The diagnosis and management of von Willebrand disease: a United Kingdom Haemophilia Centre Doctors Organization guideline approved by the British Committee for Standards in Haematology" British Journal of Haematology (2014)
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