Bleeding disorders can be confusing to patients and families and can be tricky to diagnose and treat. At Regatta Health, we have the expertise and experience to diagnose and treat multiple types of bleeding disorders. Bleeding disorders, where the blood is too thin, can lead to significant bleeding either during or after an invasive procedure, or at any time.
Across all patients, von Willebrand’s Disease (vWD) is the most common diagnosed bleeding disorder. It can manifest with bleeding symptoms like nosebleeds, bleeding around the time of surgery, gum bleeding with tooth extraction, or heavy menstrual periods. Lab testing can show a prolonged PTT clotting time. Specialized testing can reveal a vWD diagnosis. Treatments may include a nasal inhaler called ddAVP, or replacement with clotting factors like Humate-P® or Vonvendi®.
Occasionally we do also find clotting factor deficiencies, known as hemophilia. Factor VIII (8) deficiency is the most common and actual cases are only seen in males. There are many other hemophilias besides Factor VIII hemophilia (Hemophilia A) but thankfully these are rare. Current guidelines include prophylactic treatment to prevent bleeding problems.
Many patients are referred for a prolonged PTT (partial thromboplastin) or PT (prothrombin time) on lab testing prior to a procedure. Many surgeons and other doctors routinely order these clotting times to “clear” a patient for surgery. Usually abnormal clotting results do not reflect a real problem with blood clotting, but they usually require a workup in the office to rule out any kind of underlying blood disease and to assess the risk of surgery or other procedures.
Antibodies like antiphospholipid antibodies can also cause prolonged clotting times. This is known as “Hughes’ Syndrome” and can cause thickening of the blood.
The key to evaluating a suspected bleeding disorder is a careful history from the patient and then evaluation of the prior lab tests and planning a set of lab tests to work up the potential problem. Ideally this evaluation happens well before any planned procedure to reduce any delay to a procedure if it becomes more urgent. Sometimes we have to do testing while the patient is planning to have a procedure soon, so we try to proceed with due caution while trying to get the answer ASAP.
As board-certified hematologists, Dr. Benjamin and Dr. Melkonian are able to evaluate your potential bleeding disorder and recommend the right testing program to make an accurate and rapid diagnosis. They have treated many patients with hemophilia, von Willebrand’s Disease, and other bleeding disorders. Making a rapid diagnosis could improve the safety of procedures you might be planning, or reduce the risk of bleeding during your daily routine.