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| == Differential Diagnosis ==
| | __NOTOC__ |
| Different causes of the bleeding disorders can be differentiated based on their clinical manifestation and laboratory findings.
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| These features have discussed in the below table:
| | [[Sandbox: wdx]] |
| {|
| | |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
| | [[Xyz]] |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Sub-category
| | |
| ! colspan="2" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases
| | [[Abc]] |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |History
| | # [[Sandbox:Preeti]] |
| ! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestation
| | # [[Lymphoma]] |
| ! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Laboratory testing
| | # [[Breast lumps differential diagnosis]] |
| ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Comments
| | # [[Neck masses differential diagnosis]] |
| | # [[Leukemia]] |
| | {| class="wikitable" |
| | |+ |
| | |- |
| | | colspan="2" |[[:Category:Risk calculator]] |
| | [[Category:Risk calculator]] |
| | |- |
| | | colspan="2" |[[Deep vein thrombosis assessment of clinical probability and risk scores]] |
| | |- |
| | | colspan="2" |[[Pulmonary embolism assessment of clinical probability and risk scores]] |
| | |- |
| | |[[Padua prediction score]] |
| | |[[widget:PaduaVTEscore]] |
| |- | | |- |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mucosal bleeding
| | |[[IMPROVE risk score calculator]] |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Petechia
| | |[[Widget:IMPROVEScore]] |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ecchymoses
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Menorrhagia
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hematoma
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hemarthrosis
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Platelet count
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Bleeding time (BT)
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Prothrombin time (PT)
| |
| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Activated partial thromboplastin time (aPTT)
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| ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Thrombin time (TT)
| |
| |- | | |- |
| ! rowspan="14" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet disorders
| | |[[IMPROVEDD risk score calculator]] |
| ! rowspan="7" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Thrombocytopenia]]
| | |[[Widget:IMPROVEDDScore]] |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Infection]]-Induced [[thrombocytopenia]]<span name="harr_c115s002s001s002p001"></span><span name="9100754"></span>
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * History of prior infection
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Medication|Medications]]-Induced [[Thrombocytopenia|thrombocy]]<span name="harr_c115s002s001s003p001"></span><span name="9100757"></span>[[Thrombocytopenia|topenia]]
| | |[[Caprini score calculator]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:CapCal]] |
| *History of [[Medication|medications]] such as:
| |
| ** [[Furosemide]]
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| ** [[Non-steroidal anti-inflammatory drug|Nonsteroidal anti-inflammatory drugs]] ([[Non-steroidal anti-inflammatory drug|NSAIDs]])
| |
| ** [[Penicillin]]
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| ** [[Quinidine]]
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| ** [[Quinine]]
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| ** [[Ranitidine]]
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| ** [[Sulfonamide (medicine)|Sulfonamides]]
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| ** [[Linezolid]]
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
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| | align="center" style="background:#F5F5F5;" | Most important part of treatment is discontinuing of the medication.
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Heparin-Induced Thrombocytopenia|Heparin-Induced thrombocytopenia]]<span name="harr_c115s002s001s004p001"></span><span name="9100761"></span>
| | |[[Wells score calculator for DVT]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:DVT Wells score calculator]] |
| * [[Thrombosis]]
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| * Unexplained [[thrombocytopenia]] up to 3 weeks after the end of [[heparin]] therapy
| |
| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
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| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | For more information click here: [[Heparin-induced thrombocytopenia]].
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Idiopathic thrombocytopenic purpura|Immune Thrombocytopenic Purpura]] ([[Idiopathic thrombocytopenic purpura|ITP]])<span name="harr_c115s002s001s005p001"></span><span name="9100771"></span>
| | |[[Modified Wells score calculator for DVT]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:DVT Modified Wells score calculator]] |
| * History of prior [[infection]] or no history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
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| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Inherited [[Thrombocytopenia]]<span name="harr_c115s002s001s006p001"></span><span name="9100783"></span>
| | |[[Pulmonary embolism Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" | | | |[[widget:PE_calculator]] |
| * Positive family history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Thrombotic thrombocytopenic purpura|Thrombotic Thrombocytopenic Purpura]] ([[Thrombotic thrombocytopenic purpura|TTP]])<span name="harr_c115s002s002s001p001"></span><span name="9100787"></span>
| | |[[Pulmonary embolism modified Wells score calculator]] |
| | align="left" style="background:#F5F5F5;" | History of: | | |[[Widget:PE Modified Wells score calculator]] |
| *[[Cancer]]
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| *[[Bone marrow transplantation]]
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| *[[Pregnancy]]
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| *[[Medication]]
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| **[[Platelet]] aggregation inhibitors ([[ticlopidine]] and [[clopidogrel]])
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| **Immunosuppressants ([[cyclosporine]], [[mitomycin]], [[tacrolimus]]/FK506, [[interferon|interferon-α]])
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| *[[HIV-1]] infection
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
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| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Hemolytic-uremic syndrome|Hemolytic Uremic Syndrome]]<span name="harr_c115s002s002s002p001"></span><span name="9100796"></span>
| | |[[AMUSE score calculator]] |
| | align="left" style="background:#F5F5F5;" |History of: | | |[[Widget:AMUSE_score_calculator]] |
| * [[Infections]]
| |
| * [[Malignancy]], [[chemotherapy]], and [[ionizing radiation]]
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| * [[Calcineurin inhibitor]]s and [[transplantation]]
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| * [[Pregnancy]], [[HELLP syndrome]], and [[oral contraceptive pill]]
| |
| * [[Systemic lupus erythematosis]]
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| * [[Antiphospholipid syndrome|Antiphospholipid antibody syndrome]]
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| * [[Glomerulopathy]]
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| |- | | |- |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |Thromobcytosis
| | |[[HAMILTON score calculator]] |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Iron deficiency anemia|Iron deficiency anemia]]
| | |[[Widget:HAMILTON_score_calculator]] |
| Inflammatory diseases
| | |- |
| | | |[[Geneva score calculator]] |
| [[Splenectomy]] | | |[[Widget:Geneva_score_calculator]] |
| | | |- |
| [[Essential thrombocytosis|Essential thrombocytosis]]
| | |[[Revised Geneva score calculator]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:Revised_Geneva_score_calculator]] |
| * Digital [[pain]]
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| * [[Gangrene]]
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| * [[Erythromelalgia]]
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| * H[[eadache]]
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| * [[Paresthesia|Paresthesias]]
| |
| * [[Transient ischemic attack|Transient ischemic attacks]]
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" |±
| |
| | align="center" style="background:#F5F5F5;" |±
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| |- | | |- |
| ! rowspan="6" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Qualitative Disorders of [[Platelet]] Function<span name="harr_c115s002s004s001p001"></span><span name="9100803"></span>
| | |[[Simplified Geneva Score calculator]] |
| ! rowspan="4" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Inherited Disorders of [[Platelet]] Function<span name="harr_c115s002s004s001p001"></span><span name="9100803"></span>
| | |[[Widget:Simplified_Geneva_score_calculator]] |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Glanzmann's thrombasthenia|Glanzmann’s thrombasthenia]]
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Positive family history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | Rare
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * AR inheritance
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| * Absence of the platelet Gp IIb/IIIa receptor
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| * Diminished for GP 2B-3A on [[Flow cytometry|flow cytometry]]
| |
| |- | | |- |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Bernard-Soulier syndrome]]
| | |[[TIMI Risk Score for Unstable Angina or NSTEMI]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:TIMI_UA_NSTEMI]] |
| * Positive family history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * AR inheritance
| |
| * Absence of the platelet Gp Ib-IX-V receptor
| |
| * On PBS: giant platelets
| |
| * Ristocetin - no aggregation
| |
| |- | | |- |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Wiskott-Aldrich syndrome]]
| | |[[TIMI Risk Score for STEMI]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:TIMI_STEMI]] |
| * Positive family history
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Anti-WASP antibody can be used to detect presence or absence of WAS protein
| |
| * In Wiskott–Aldrich syndrome, the [[Platelet|platelets]] are small and do not function properly. They are removed by the [[spleen]], which leads to low [[platelet]] counts.
| |
| |- | | |- |
| ! align="left" style="padding: 5px 5px; background: #DCDCDC;" |[[Platelet storage pool deficiency|Platelet storage pool disorder (SPD)]]:
| | |[[Tygerberg score]] |
| *[[Hermansky-Pudlak syndrome]]
| | |[[widget:Tygerberg_score]] |
| *[[Chediak-Higashi syndrome]]
| |
| *[[Gray platelet syndrome]]
| |
| | align="center" style="background:#F5F5F5;" |
| |
| * Positive family history
| |
| * [[Hairy cell leukemia]]
| |
| * [[Cardiovascular bypass]]
| |
| | align="center" style="background:#F5F5F5;" | +
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * AD inheritance
| |
| * Abnormalities of platelet granule formation
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Acquired Disorders of [[Platelet]] Function<span name="harr_c115s002s004s002p001"></span><span name="9100808"></span>
| | |[[CHA2DS2-VASc Score]] |
| | align="left" style="background:#F5F5F5 " | | | |[[Widget:CHA2DS2VASc]] |
| * [[Chronic renal failure pathophysiology|Uremia]]
| |
| * [[Cardiopulmonary bypass]]
| |
| * Hematologic disorders such as: [[Myeloproliferative disease|myeloproliferative]] and [[Myelodysplastic syndrome|myelodysplastic syndromes]]
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" |±
| |
| | align="center" style="background:#F5F5F5;" |±
| |
| | align="center" style="background:#F5F5F5;" | Normal or ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | −
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Von Willebrand disease|Von Willebrand Disease]]<span name="harr_c115s002s005p001"></span><span name="9100810"></span>
| | |[[CHADS2 score]] |
| | align="left" style="background:#F5F5F5;" | | | |[[Widget:CHADS2score]] |
| * Easy bruising
| |
| * [[Epistaxis]]
| |
| * Oral cavity bleeding
| |
| * Bleeding after dental extraction/surgery
| |
| * [[Menorrhagia]]
| |
| * [[Postpartum hemorrhage]]
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" | <nowiki>+</nowiki>
| |
| | align="center" style="background:#F5F5F5;" |±
| |
| | align="center" style="background:#F5F5F5;" |±
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | Normal
| |
| | align="center" style="background:#F5F5F5;" | See the table below for the details about different types.
| |
| |- | | |- |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Vessel wall disorders
| | |[[HAS-BLED score]] |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Metabolism|Metabolic]] and [[Inflammation|Inflammatory]] Disorders
| | |[[Widget:HASBLEDscore]] |
| ! colspan="2" |
| |
| * Acute febrile illnesses
| |
| * [[Cryoglobulinemia|Mixed cryoglobulinemia]]
| |
| * [[Monoclonal gammopathy|Monoclonal gammopathies]]
| |
| * Certain pathogens, such as the rickettsiae causing [[Rocky Mountain spotted fever]]
| |
| * [[Vitamin C]] deficiency
| |
| * [[Cushing's syndrome|Cushing’s syndrome]]
| |
| * Chronic [[glucocorticoid]] therapy
| |
| * [[Ageing|Aging]]
| |
| * [[Vasculitis]] such as Henoch-Schönlein,
| |
| |
| |
| * History of the underlying disease.
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |±
| |
| | −
| |
| | −
| |
| |Normal
| |
| |↑/Normal
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |−
| |
| |- | | |- |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |Inherited Disorders of the [[Vessel wall|Vessel Wall]]
| | |[[The GRACE risk score]] |
| ! colspan="2" |
| | |[[Widget:GRACEscore]] |
| * [[Marfan's syndrome|Marfan’s syndrome]]
| |
| * [[Ehlers-Danlos syndrome]]
| |
| * [[Pseudoxanthoma elasticum]]
| |
| * [[Hereditary hemorrhagic telangiectasia]] ([[Hereditary hemorrhagic telangiectasia|HHT]], or [[Osler-Weber-Rendu|Osler-Weber-Rendu disease]])
| |
| |
| |
| * Positive family history
| |
| |−
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |±
| |
| | −
| |
| | −
| |
| |Normal
| |
| |↑/Normal
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |−
| |
| |- | | |- |
| ! rowspan="12" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Coagulation factor disorders
| |
| <ref name="pmid28966616" />
| |
| ! align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Fibrinogen]] deficiency
| |
| ! colspan="2" |Different types of the [[fibrinogen]] disorders:
| |
| * [[Fibrinogen#Congenital afibrinogenemia|Congenital afibrinogenemia]]
| |
| * [[Fibrinogen#Congenital hypofibrinogenemia|Congenital hypofibrinogenemia]]
| |
| * [[Fibrinogen#Fibrinogen storage disease|Fibrinogen storage disease]]
| |
| * [[Fibrinogen#Congenital dysfibrinogenemia|Congenital dysfibrinogenemia]]
| |
| * [[Fibrinogen#Hereditary fibrinogen A.CE.B1-Chain amyloidosis|Hereditary fibrinogen Aα-Chain amyloidosis]]
| |
| * [[Fibrinogen#Acquired dysfibrinogenemia|Acquired dysfibrinogenemia]]
| |
| * [[Fibrinogen#Congenital hypodysfibrinogenemia|Congenital hypodysfibrinogenemia]][[Fibrinogen#Cryofibrinogenemia|Cryofibrinogenemia]]
| |
| * [[Fibrinogen#Acquired hypofibrinogenemia|Acquired hypofibrinogenemia]]
| |
| | | | | |
| * [[Epistaxis]]
| |
| * Easy [[Bruise|bruising]]
| |
| * [[Menorrhagia]]
| |
| * [[Muscle]] bleeds
| |
| * [[Hemarthrosis]]
| |
| * [[Bleeding]] from the [[umbilical cord]] stump after birth
| |
| * Bleeding after [[dental surgery]] or tooth extraction
| |
| * Abnormal bleeding during or after injury, surgery, or childbirth
| |
|
| |
| * [[Gastrointestinal tract|Gastrointestinal]] [[hemorrhage]]
| |
| * [[Cerebral hemorrhage]]
| |
| * [[Thrombosis]]
| |
| |−
| |
| | −
| |
| | +
| |
| | +
| |
| |±
| |
| | +
| |
| |Normal
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |↑
| |
| | | | | |
| * Impaired fibrin cross linking or clot dissolution.
| |
|
| |
| * The severity of bleeding in patients with fibrinogen disorders can be mild or severe, with higher bleeding risk in those with afibrinogenemia or lower levels of functional fibrinogen. The age of onset is also variable, with earlier onset in those with more severe deficiency.
| |
| |- | | |- |
| ! colspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Prothrombin deficiency]]
| | |[[Ranson criteria]] |
| | | | [[Acute pancreatitis diagnostic criteria]] |
| * Easy [[bruising]]
| | |[[Widget:RansonScore]] |
| * [[Epistaxis]]
| | |- |
| * Soft-tissue hemorrhage
| | |[[Apgar score]] |
| * Excessive postoperative bleeding
| | |[[Widget:Apgarscore]] |
| * [[Menorrhagia]]
| | |- |
| * Muscle [[Hematoma|hematomas]]
| | |[[Glasgow coma scale]] |
| * [[Hemarthrosis]]
| | |[[Widget:Adult_GCS]] |
| * [[Intracranial hemorrhage|Intracranial]] bleeding
| | |- |
| |− | | |[[Pediatric Glasgow Coma Scale]] |
| |<nowiki>+</nowiki> | | |[[Widget:PGCS]] |
| |<nowiki>+</nowiki> | | |- |
| |<nowiki>+</nowiki> | | |[[Cincinnati stroke scale]] |
| |<nowiki>+</nowiki> | | |[[Widget:Cincinnati_Stroke_Scale]] |
| |<nowiki>+</nowiki> | | |- |
| |Normal | | |[[DIPSS Plus Score]] |
| |Normal | | |[[Widget:DIPSS_Plus_Score]] |
| |↑ | | |- |
| |↑ | | | colspan="2" |[[ICU scoring systems]] |
| |↑ | | |- |
| |− | | |[[APACHE II]] |
| | |[[Widget:APACHEII]] |
| | |- |
| | |[[SAPS II]] |
| | |[[Widget:SAPSII]] |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor V deficiency]]
| | |[[SAPS III]] |
| | | | |[[Widget:SAPSIII]] |
| * Excessive bruising with minor injuries
| |
| * [[Epistaxis]]
| |
| * [[Hemarthrosis]]
| |
| * [[Menorrhagia]]
| |
| * [[Intracerebral hemorrhage|Intracerebral hemorrhages]]
| |
| * [[Pulmonary hemorrhage]]
| |
| |−
| |
| |_
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| | +
| |
| |Normal
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |Normal
| |
| |The severity of bleeding is only partly related to the degree of factor V deficiency. Some patients with undetectable plasma levels of factor V experience only relatively mild bleeding.
| |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor VII deficiency]]
| | |[[PIM2]] |
| | | | | |
| * Easy [[Bruise|bruising]]
| | |} |
| * Mucosal bleeding
| | ==Table== |
| * Postoperative bleeding
| | {| |
| * [[Menorrhagia]]
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Complications |
| * Soft tissue hematomas
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Polymyositis |
| * [[Thrombosis]]
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dermatomyositis |
| | | |
| | | |
| |
| |
| |<nowiki>+</nowiki>
| |
| | + | |
| | +
| |
| |Normal
| |
| |
| |
| |↑
| |
| |Normal
| |
| |Normal
| |
| |Thrombosis occurs in inherited factor VII deficiency most cases are associated with the administration of factor VII replacement therapy | |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor X deficiency]] | | ! align="center" style="background:#DCDCDC;" + |[[Cancer|Malignancy]] |
| | | | | align="left" style="background:#F5F5F5;" + | |
| * Prolonged bleeding following circumcision
| | *[[Lung]] |
| | | align="left" style="background:#F5F5F5;" + | |
| | *[[Lung]] |
| | |} |
| | <br> |
| | ===Calculation of the Padua Prediction Score=== |
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
|
| |
|
| * Easy [[Bruise|bruising]]
| | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| * [[Hematuria]]
| | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| * [[Menorrhagia]]
| | |- |
| * Abortion
| | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| * Postpartum hemorrhage
| | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| * Epistaxis
| | |- |
| * Pseudotumors
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active gastric or duodenal ulcer |
| * Intracranial bleeding
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4.5 |
| * Hemarthroses
| | |- |
| | | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Prior bleeding within the last 3 months |
| |<nowiki>+</nowiki> | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| | + | | |- |
| | + | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Thrombocytopenia (<50x10<sup>9</sup>/L) |
| | + | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| | + | | |- |
| |Normal | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age ≥ 85 years |
| |Normal | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |3.5 |
| |↑ | | |- |
| |↑ | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Liver failure (INR>1.5) |
| |Normal | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| |− | | |- |
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Severe kidney failure (GFR< 30 mL/min/m<sup>2</sup>) |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor XII|Factor XII deficiency]] | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Admission to ICU or CCU |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| * Majority,asymptomatic
| |
| * Recurrent miscarriages
| |
| * Painful leg ulcers
| |
| |
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| |
| |
| |- | | |- |
| ! colspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[High-molecular-weight kininogen|High molecular weight kininogen (HMWK)]] deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Central venous catheter |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| * Possibility of positive family history of bleeding
| |
| |
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| | | |
| |- | | |- |
| ! colspan="3" rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Prekallikrein]] deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Rheumatic disease |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| * Possibility of positive family history of bleeding
| |
| |
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |_
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| |
| |
| |- | | |- |
| ! rowspan="1" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Factor XIII deficiency]] | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active malignancy |
| ! colspan="2" |Types:
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| * Sub unit A mutation disease (more common)
| |
| * Sub unit B mutation disease
| |
| | | |
| * Possibility of positive family history of bleeding
| |
| |±
| |
| |±
| |
| |±
| |
| |±
| |
| |±
| |
| |±
| |
| |Normal
| |
| |Normal
| |
| |Normal/↑
| |
| |Normal
| |
| |Normal
| |
| |
| |
| * Impaired fibrin cross linking or clot dissolution
| |
| * The severity of factor XIII deficiency bleeds can be different in different patients
| |
| |- | | |- |
| ! rowspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Hemophilia]] | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age: 40-84 years |
| | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1.5 |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Type A deficiency
| |
| |
| |
| * Eeasy [[Bruise|bruising]]
| |
| * Inadequate clotting in [[trauma]] or mild injury
| |
| * Spontaneous hemorrhage
| |
| * [[Hemarthrosis]]
| |
| * [[Epistaxis]]
| |
| * [[Gingival bleeding]]
| |
| | −
| |
| | −
| |
| | −
| |
| | +
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| |−
| |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Type B deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| | | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| * Neonatal bleeding
| |
| * Trauma-related soft-tissue hemorrhage
| |
| * [[Hemarthrosis]]
| |
| * [[Hematoma|Hematomas]]
| |
| | −
| |
| | −
| |
| | −
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| |− | |
| |- | | |- |
| ! colspan="2" align="center" style="padding: 5px 5px; background: #DCDCDC;" |Type C deficiency | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Moderate kidney failure (GFR: 30-59 mL/min/m<sup>2</sup>) |
| |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| * Family history
| |
| * Bleeding after surgery or injury
| |
| | −
| |
| | −
| |
| | −
| |
| |<nowiki>+</nowiki>
| |
| |Rare | |
| |Rare
| |
| |Normal
| |
| |Normal
| |
| |Normal
| |
| |↑
| |
| |Normal
| |
| | − | |
| |- | | |- |
| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rare diseases | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
| ! colspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Disseminated intravascular coagulation|Disseminated Intravascular Coagulation]]
| |
| !
| |
| * [[Trauma]]
| |
| * Burn
| |
| * [[Crush injury]]
| |
| * [[Sepsis]]
| |
| * [[Malignancy]]
| |
| * Obstetric complication: abruption, amniotic fluid embolism
| |
| * [[Hemolytic anemia]]
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |↓
| |
| |↑
| |
| |↑
| |
| |↑
| |
| |Normal
| |
| | −
| |
| |- | | |- |
| ! colspan="3" align="center" style="padding: 5px 5px; background: #DCDCDC;" |[[Vitamin K Deficiency]] | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
| !
| |
| * Bleeding after trauma
| |
| * [[Epistaxis]]
| |
| * [[Hematoma]]
| |
| * Gastrointestinal bleeding
| |
| * [[Menorrhagia]]
| |
| * [[Hematuria]]
| |
| * Gum bleeding
| |
| * Oozing from venipuncture sites
| |
| * Easy [[Bruise|bruisability]]
| |
| |<nowiki>+</nowiki>
| |
| | −
| |
| | +
| |
| | +
| |
| |<nowiki>+</nowiki>
| |
| |<nowiki>+</nowiki>
| |
| |Normal
| |
| |↑
| |
| |↑
| |
| |Normal or mildly prolonged
| |
| |Normal
| |
| | −
| |
| |} | | |} |
| Different types of Von-Willebrand diseases can be differentiated from each other based on the following table:
| | <br style="clear:left" /> |
| | |
| | ===Calculation of the test Prediction Score=== |
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
|
| |
|
| {| | | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type of VWD
| | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type of factor deficiency
| | |- |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Prevalence
| | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inheritance pattern | | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
| | |- |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |VWF activity | | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Gender |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RIPA | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Female |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Factor VIII | | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| | |- |
| | ! rowspan="4" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |0-70 |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |71-80 |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |81-90 |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>90 |
| | |- |
| | ! rowspan="5" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Hgb ('''g/dL)''' |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>17 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15.5-17 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-15.5 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-11 '''g/dL''' |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<11 '''g/dL''' |
| | |- |
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |CrCl (mL/min) |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |30-60 mL/min |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15-30 mL/min |
| | |- |
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Albumin |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>3.5 g/dL |
| | |- |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≤3.5 g/dL |
| | |- |
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |D-dimer |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≥1 µg/mL |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" |Type 1
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<1 µg/mL |
| | align="center" style="background:#F5F5F5;" | Quantitative/ partial
| |
| | align="center" style="background:#F5F5F5;" | 60-70%
| |
| | align="center" style="background:#F5F5F5;" | AD
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Bleeding severity mild to severe
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| |- | | |- |
| ! rowspan="4" align="center" style="background:#DCDCDC;" |Type 2 | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |ICU admission |
| ! align="center" style="background:#DCDCDC;" |2A
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | align="center" style="background:#F5F5F5;" | Qualitative | |
| | align="center" style="background:#F5F5F5;" | 10%
| |
| | align="center" style="background:#F5F5F5;" | AD/AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Moderate to severe [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | N or ↓
| |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" |2B | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Acute stroke on hospitalization |
| | align="center" style="background:#F5F5F5;" | Qualitative
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | align="center" style="background:#F5F5F5;" | 5%
| |
| | align="center" style="background:#F5F5F5;" | AD
| |
| | align="left" style="background:#F5F5F5;" | | |
| * [[Thrombocytopenia]]
| |
| * Moderate to severe [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↑
| |
| | align="center" style="background:#F5F5F5;" | N or ↓
| |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" |2M | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |History of VTE |
| | align="center" style="background:#F5F5F5;" | Qualitative
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | align="center" style="background:#F5F5F5;" | <1% | |
| | align="center" style="background:#F5F5F5;" | AD/AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Moderate to severe [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | N or ↓
| |
| |- | | |- |
| ! align="center" style="background:#DCDCDC;" |2N | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
| | align="center" style="background:#F5F5F5;" | Qualitative
| |
| | align="center" style="background:#F5F5F5;" | <1%
| |
| | align="center" style="background:#F5F5F5;" | AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Clinically similar to [[hemophilia A]] with [[joint]], [[soft tissue]], [[urinary]] [[bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | N
| |
| | align="center" style="background:#F5F5F5;" | N
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| |- | | |- |
| ! colspan="2" align="center" style="background:#DCDCDC;" |Type 3 | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
| | align="center" style="background:#F5F5F5;" | Complete deficiency
| |
| | align="center" style="background:#F5F5F5;" | 1-2%
| |
| | align="center" style="background:#F5F5F5;" | AR
| |
| | align="left" style="background:#F5F5F5;" |
| |
| * Clinically similar to [[hemophilia A]] with [[joint]] and [[soft tissue]] [[bleeding]]
| |
| * Severe [[mucosal bleeding]]
| |
| | align="center" style="background:#F5F5F5;" | Absent
| |
| | align="center" style="background:#F5F5F5;" | ↓
| |
| | align="center" style="background:#F5F5F5;" | Low, 1-10%
| |
| |} | | |} |
| For more information on Von Willebrand disease, click [[ von willebrand disease | here]].
| | <br style="clear:left" /> |
| | |
| | ===Interpretation of the Padua Prediction Score=== |
| | The interpretation of the score is as follows: |
| | * Score ≥ 4: High risk for VTE |
| | * Score < 4: Low risk for VTE |
| | ==References== |
| <references /> | | <references /> |