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Haemostatic disorders in habitual nose-bleeders

  • Martin Beran (a1), Lennart Stigendal (a2) and Björn Petruson (a1)


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.


Corresponding author

M. Beran, M.D., ENT-Department, Uddevalla Hospital, S-451 80 Uddevalla, Sweden.


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Bachmann, F. (1980) Diagnostic approach to mild bleeding disorders. Seminars in Hematology, 17: 292305.
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.
Beran, M and Petruson, B. (1986a) Changes in the nasal mucosa of habitual nose-bleeders. Acta Oto-Laryngologica (Stockholm). 102: 308314.
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.
Born, G. V. R. and Cross, M. J. (1963). The aggregation of blood platelets. Journal of Physiology, 168: 178195.
Brown, E. E. (1949) Evaluation of new capillary resistometer; petechiometer. Journal of Laboratory and Clinical Medicine, 34: 17141717.
Bull, B. S., Schneiderman, M. A. and Brecher, G. (1965) Platelet counts with the Coulter Counter. American Journal of Clinical Pathology, 44: 678688.
Clauss, A. (1957) Gerinnungsphysiologische Schnellmethode zur bestimmung des Fibrinogens. Acta Haematologica, 17: 237246.
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.
Cronberg, S. (1968) Investigations in haemorrhagic disorders with prolonged bleeding time but normal number of platelets. Acta Medica Scandinavica. Supplementum 486.
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).
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.
Forfar, J. C. (1979) A 7-year analysis of haemorrhage in patients on long-term anticoagulant treatment. British Heart Journal, 42: 128132.
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.
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.
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.
Hellem, A. J. (1960) The adhesiveness of human blood platelets in vitro. Scandinavian Journal of Clinical and Laboratory Investigation 12, Supplement 51: 1117.
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.
Kiley, V., Stuart, J. J. and Johnson, C. A. (1982) Coagulation studies in children with isolated recurrent epistaxis. Journal of Pediatrics, 100: 579581.
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.
Korsan-Bengtsen, K. (1970) Comparison between various methods used to control dicumarol therapy. Acta Medica Scandinavica, 188: 327335.
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.
Kwaan, H. C. and Silverman, S. (1973) Fibrinolytic activity in lesions of hereditary hemorrhagic telangiectasia. Archives of Dermatology, 107: 571573.
Laurell, C. B. (1966) Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies. Analytical Biochemistry, 15: 4552.
Marder, V. J. and Shulman, N. R. (1964) Clinical aspects of congenital factor VII deficiency. American Journal of Medicine, 37: 182194.
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.
Petruson, B. (1974) Epistaxis, a clinical study with special references to fibrinolysis. Acta Oto-Laryngologica (Stockholm), Supplement 317.
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.
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.
Seeler, R. A. (1972) Parahemophilia, Factor V deficiency. Medical Clinics of North America, 56: 119125.
Silver, J. (1973) von Willebrand's disease in Sweden. Acta paediatrica Scandinavica, Supplementum 238: 8588.
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.
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.
Svensson, J., Blombäck, M. and Kockum, C. (1985) High frequency of haemorrhagic complications in anticoagulant therapy. Läkartidningen, 82 (14): 12401244.
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.
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.
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