Merck Manual

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Overview of Vascular Bleeding Disorders

By

David J. Kuter

, MD, DPhil, Harvard Medical School

Reviewed/Revised May 2023
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Bleeding may result from abnormalities in

Vascular bleeding disorders result from defects in blood vessels, typically causing cutaneous or mucosal lesions called petechiae, purpura, and ecchymoses depending on their size but, except for hereditary hemorrhagic telangiectasia Hereditary Hemorrhagic Telangiectasia Hereditary hemorrhagic telangiectasia is a hereditary disorder of vascular malformation transmitted as an autosomal dominant trait affecting men and women. (See also Overview of Vascular Bleeding... read more Hereditary Hemorrhagic Telangiectasia , seldom leading to serious blood loss. Small lesions (< 2 mm) are termed petechiae, and larger lesions are termed purpura if they are > 2 mm and <10 mm or ecchymoses if > 10 mm.

In vascular bleeding disorders, results of tests of hemostasis Laboratory Tests of Hemostasis by Phase Laboratory Tests of Hemostasis by Phase are usually normal. For most disorders, diagnosis is clinical; specific tests are available for some (eg, immunoglobulins in specific dysproteinemias).

Treatment focuses on controlling the bleeding when possible and providing supportive care. Some patients require blood transfusions. Many patients require iron therapy to replace iron lost due to repeated mucosal bleeding (see treatment of Iron Deficiency Anemia Treatment Iron deficiency is the most common cause of anemia and usually results from blood loss; malabsorption, such as occurs in celiac disease, is a much less common cause. Symptoms are usually nonspecific... read more Treatment ).

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