Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-28T18:49:43.371Z Has data issue: false hasContentIssue false

Haemostatic disorders in habitual nose-bleeders

Published online by Cambridge University Press:  29 June 2007

Martin Beran*
Affiliation:
Department of otolaryngologyUniversity of Göteborg, Göteborg, Sweden.
Lennart Stigendal
Affiliation:
Coagulation Laboratroy, Department of Medicine II, University of Göteborg, Göteborg, Sweden.
Björn Petruson
Affiliation:
Department of otolaryngologyUniversity of Göteborg, Göteborg, Sweden.
*
M. Beran, M.D., ENT-Department, Uddevalla Hospital, S-451 80 Uddevalla, Sweden.

Abstract

Ninety-one habitual nose-bleeders were screened for haemostatic disorders. 46 screening results in 38 nose-bleeders were outside the normal range. After extended investigation, it was found that 25 (27 per cent) habitual nose-bleeders had haemostatic disorders, all except one in the primary haemostasis. The disorders found could be classified as mild bleeding disorders (MBD) and compared to the estimated frequency of MBD in the population there was an increased incidence of haemostatic disorders in the habitual nose-bleeders. Abnormal vessels in the nasal mucosa were present in 85 per cent of the investigated nose-bleeders, equaly distributed between nose-bleeders with and without haemostatic disorders. This indicates that abnormal vessels and haemostatic disorders occur independently of each other. When screening for haemostatic disorders in habitual nose-bleeders, it is possible to detect previously unknown but clinically important disorders.

Type
Research Article
Copyright
Copyright © JLO (1984) Limited 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bachmann, F. (1980) Diagnostic approach to mild bleeding disorders. Seminars in Hematology, 17: 292305.Google ScholarPubMed
Babson, A. L. and Babson, S. R. (1974) Comparative evaluation of partial thromboplastin reagent containing a non-settling, particulate activator. American Journal of Clinical Pathology, 62: 856860.CrossRefGoogle ScholarPubMed
Beran, M and Petruson, B. (1986a) Changes in the nasal mucosa of habitual nose-bleeders. Acta Oto-Laryngologica (Stockholm). 102: 308314.CrossRefGoogle ScholarPubMed
Beran, M. and Petruson, B. (1986b) Occurrence of epistaxis in habitual nose-bleeders and analysis of some etiological factors. ORL. Journal of Oto-Rhino-Laryngology and its related specialities. 48: 297303.CrossRefGoogle Scholar
Born, G. V. R. and Cross, M. J. (1963). The aggregation of blood platelets. Journal of Physiology, 168: 178195.CrossRefGoogle ScholarPubMed
Brown, E. E. (1949) Evaluation of new capillary resistometer; petechiometer. Journal of Laboratory and Clinical Medicine, 34: 17141717.Google Scholar
Bull, B. S., Schneiderman, M. A. and Brecher, G. (1965) Platelet counts with the Coulter Counter. American Journal of Clinical Pathology, 44: 678688.CrossRefGoogle ScholarPubMed
Clauss, A. (1957) Gerinnungsphysiologische Schnellmethode zur bestimmung des Fibrinogens. Acta Haematologica, 17: 237246.CrossRefGoogle Scholar
Conlon, C. L., Weinger, R. S., Cimo, P. L., Moake, J. L. and Olson, J. D. (1978) Telangiectasia and von Willebrand's disease in 2 families. Annals of Internal Medicine, 89: 921924.CrossRefGoogle Scholar
Cronberg, S. (1968) Investigations in haemorrhagic disorders with prolonged bleeding time but normal number of platelets. Acta Medica Scandinavica. Supplementum 486.CrossRefGoogle ScholarPubMed
Duray, P. H., Marcal, J. M., Livolsi, V. A., Fischer, R., Scholhamer, C. and Brand, M. H. (1983) Small intestinal angiodysplasia—A possible component of von Willebrand's disease. Laboratory Investigation, 48: A22 (meeting abstract).Google Scholar
Edson, J. R., White, J. G. and Krivit, W. (1967) The enigma of severe factor XI deficiency without hemor-rhagic symptoms. Thrombosis et Diathesis Haemorrhagica, 18: 342348.Google Scholar
Forfar, J. C. (1979) A 7-year analysis of haemorrhage in patients on long-term anticoagulant treatment. British Heart Journal, 42: 128132.CrossRefGoogle ScholarPubMed
George, J. N. and Reimann, T. A. (1982) Inherited disorders of the platelet membrane: Glanzmann's thrombastenia and Bernard-Soulierdisease. In: Colman, R. W., Hirsh, J., Marder, V. J. and Salzman, E. W., eds. Hemostasis and thrombosis: Basic principles and clinical practice, Philadelphia: J. B. Lip-pincott Company, pp. 496506.Google Scholar
Girolami, A., Molaro, G., Lazzarin, M., Scarpa, R. and Brunetti, A. (1970) A ‘new’ congenital haemorrhagic condition due to presence of an abnormal factor X (factor X Friuli): Study of a large kindred. British Journal of Haematology, 19: 179192.CrossRefGoogle ScholarPubMed
Hardisty, R. M. and McPherson, J. C. (1962) A one-stage factor VIII (antihaemophilic globulin) assay and its use on venous and capillary plasma. Thrombosis et Diathesis Haemorrhagica, 7: 215229.Google ScholarPubMed
Hellem, A. J. (1960) The adhesiveness of human blood platelets in vitro. Scandinavian Journal of Clinical and Laboratory Investigation 12, Supplement 51: 1117.Google ScholarPubMed
Johansson, B. R., Beran, M. and Petruson, B. (1985) Light and electron microscopy of varicose vessels and telangiomas in the nasal mucosa of habitual nose-bleeders. Acta Oto-Laryngologica (Stockholm), 99: 620629.CrossRefGoogle Scholar
Kiley, V., Stuart, J. J. and Johnson, C. A. (1982) Coagulation studies in children with isolated recurrent epistaxis. Journal of Pediatrics, 100: 579581.CrossRefGoogle ScholarPubMed
Kinlough-Rathbone, R. L., Packham, M. A. and Mustard, J. F. (1983) Platelet aggregation. In measurements of platelet function. (Harker, L. A. and Zinnaman, T. S., ed.) pp. 6491, Churchill Livingstone, New York.Google Scholar
Korsan-Bengtsen, K. (1970) Comparison between various methods used to control dicumarol therapy. Acta Medica Scandinavica, 188: 327335.CrossRefGoogle ScholarPubMed
Kramar, J. (1961) Capillary resistance and its relation to bleeding. In Blood platelets. Johnson, S. A., Monto, R. W., Rebuck, J.W. and Horn, R.C. eds., pp. 4148. Jr Little Brown, Boston.Google Scholar
Kwaan, H. C. and Silverman, S. (1973) Fibrinolytic activity in lesions of hereditary hemorrhagic telangiectasia. Archives of Dermatology, 107: 571573.CrossRefGoogle ScholarPubMed
Laurell, C. B. (1966) Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies. Analytical Biochemistry, 15: 4552.CrossRefGoogle ScholarPubMed
Marder, V. J. and Shulman, N. R. (1964) Clinical aspects of congenital factor VII deficiency. American Journal of Medicine, 37: 182194.CrossRefGoogle ScholarPubMed
Nieuwenhuis, H. K. and Sixma, J. J. (1983) Bleeding time measurements. In Measurements of platelet function (Harker, L. A., Zimmerman, T. S., eds), pp. 2645, Churchill-Livingstone publication, Edinburgh.Google Scholar
Petruson, B. (1974) Epistaxis, a clinical study with special references to fibrinolysis. Acta Oto-Laryngologica (Stockholm), Supplement 317.CrossRefGoogle ScholarPubMed
Ruggeri, Z. M., Pareti, F. I., Manucci, P. M., Ciavarella, N. C. and Zimmerman, T. S. (1980) Heightened interaction between platelets and factor VIII/von Willebrand Factor in a new subtype of von Willebrand's disease. New England Journal of Medicine, 302: 10471051.CrossRefGoogle Scholar
Santoro, S. A. and Cunningham, L. W. (1981) The interaction of platelets with collagen. In Platelets in biology and pathology. Gordon, J. L. ed. pp. 249264. Elsevier/North-Holland biomedical press, Amsterdam.Google Scholar
Seeler, R. A. (1972) Parahemophilia, Factor V deficiency. Medical Clinics of North America, 56: 119125.CrossRefGoogle ScholarPubMed
Silver, J. (1973) von Willebrand's disease in Sweden. Acta paediatrica Scandinavica, Supplementum 238: 8588.Google Scholar
Stuart, M. J., Murphy, B. S. and Oski, F. A. (1975) A simple non radioisotope technique for the determination of platelet life span. New England Journal of Medicine, 292: 13101313.CrossRefGoogle Scholar
Sultan, Y., Simon, J. and Caen, J. P. (1976) Elec-trophoretic heterogeneity of normal factor VIII, von Willebrand's protein and abnormal electrophoretic mobility in patients with von Willebrand's disease. Journal of Laboratory and Clinical Medicine, 87: 185197.Google ScholarPubMed
Svensson, J., Blombäck, M. and Kockum, C. (1985) High frequency of haemorrhagic complications in anticoagulant therapy. Läkartidningen, 82 (14): 12401244.Google ScholarPubMed
Weiss, H. J., Hoyer, L. W., Rickles, F. R., Varma, A. and Rogers, J. (1973a) Quantitative assay of a plasma factor deficient in von Willebrand's disease that is necessary for platelet aggregation: Relationship to factor VIII procoagulant activity and antigen content. Journal of Clinical Investigation, 52: 27082716.CrossRefGoogle ScholarPubMed
Weiss, H. J., Rogers, J. and Brand, H. (1973b) Defective Risto-cetin-induced platelet aggregation in von Willebrand's disease and its correction by factor VIII. Journal of Clinical Investigation, 52: 26972707.CrossRefGoogle Scholar