What diseases can prolonged bleeding time be seen in

Prolonged bleeding time may indicate platelet abnormalities or vascular dysfunction, commonly seen in idiopathic thrombocytopenic purpura, hemophilia, aplastic anemia, myelodysplastic syndrome, and disseminated intravascular coagulation.

1. Thrombocytopenia:

Idiopathic thrombocytopenic purpura is caused by the immune system mistakenly attacking platelets, manifested as skin bruising, nosebleeds, or gum bleeding. Laboratory tests showed that platelet count was below 100 × 10 ⁹/L, and the number of bone marrow megakaryocytes was normal or increased. Corticosteroids are the preferred treatment drugs, and in severe cases, intravenous immunoglobulin injection is required.

2. Von Willebrand disease:

is caused by a deficiency or abnormal function of von Willebrand factor and belongs to hereditary hemorrhagic diseases. In addition to prolonged bleeding time, patients often have normal prothrombin time and prolonged activated partial thromboplastin time. Alternative treatment uses clotting factor concentrates containing von Willebrand factor, and female patients need to strengthen their protection during menstruation.

3. Bone marrow failure:

aplastic anemia leads to a decrease in whole blood cells, and damage to hematopoietic stem cells results in insufficient platelet production. Typical symptoms include anemia, infection, and bleeding tendency, with bone marrow biopsy showing adipose tissue replacing hematopoietic tissue. Immunosuppressive therapy and hematopoietic stem cell transplantation are the main intervention methods to prevent severe bleeding complications.

4. Myelodysplastic abnormalities:

Patients with myelodysplastic syndrome have pathological hematopoiesis, with abnormal platelet quantity and quality. Peripheral blood smears show varying sizes of red blood cells and reduced granulocytes, and some cases may progress to leukemia. Supportive treatment including platelet transfusion and demethylating drugs can improve the prognosis of some patients.

5. Coagulation dysfunction:

Diffuse intravascular coagulation is a secondary coagulation disorder caused by various diseases, and microthrombus formation consumes a large amount of platelets and coagulation factors. The laboratory features include decreased platelets, decreased fibrinogen, and increased D-dimer levels. Treatment should target the primary disease and supplement coagulation factors and platelets when severe bleeding occurs.

Avoid vigorous exercise and external injuries in daily life, and use a soft bristled toothbrush to reduce gum damage. Adding green leafy vegetables and animal liver rich in vitamin K to the diet can aid in the synthesis of clotting factors. Regularly monitor platelet count and coagulation function. Female patients with excessive menstrual flow should seek medical attention promptly. If the bleeding symptoms continue to worsen or central nervous system symptoms such as headache and blurred vision appear, emergency treatment is needed to prevent the risk of intracranial hemorrhage.