Bleeding disorders: 1. Thrombocytopenia 2. Glanzmanns Thrombasthenia 3. Von Willebrand Disease 4.

Liver disease or Vitamin K deficiency, which leads to defective coagulation 5. Haemophilia 6. Haemorrhagic disease of the newborn Haemophilia is an X-linked hereditary disease, meaning it only occurs in boys, though girls can be carriers of the disease. There are 2 types of haemophilia which differ according to the clotting factors which are deficient in the patients body. Haemophilia A, or classic haemophilia, results from a deficiency of factor VIII. This accounts for 85% of all haemophilia cases. The other 15% of cases are of haemophilia B, or Christmas disease, which results from a deficiency of factor IX. Haemophilia can also be caused by antibodies to these clotting factors being formed and disrupting their function. Due to the lack of these clotting factors, mild haemorrhaging can cause prolonged or excessive bleeding. The severity of the bleeding depends on the degree to which the clotting factors are deficient. The major symptoms of haemophilia are bleeding and bruises. Clinical diagnosis is done using tests to check how long it takes for blood to clot. The Activated Partial Thromboplastin Time (normally 36-42 seconds) is used to test the intrinsic pathway of coagulation, which is what would be affected by haemophilia. Treatment of haemophilia entails infusion of concentrates of the deficient clotting factor directly into the bloodstream. Von Willebrands disease is a deficiency of von Willebrand factor, which helps blood platelets clump together and stick to the blood vessel wall. Lack of this factor affects platelet function and hinders the formation of platelet plugs. Haemophilia does not affect platelet function, but rather affects the formation of the fibrous sheath which supports the platelet plug in covering the damage done to the blood vessel. While Haemophilia affects boys almost exclusively, von Willebrand disease affects men and women equally. Diagnosis of Haemophilia is done using the Activated Partial Thromboplastin Time, while Von Willebrand disease can be hard to diagnose. Tests for its diagnosis include Bleeding Time, a Platelet Aggregation Test, a Platelet Count and a Ristocetin Cofactor test (Ristocetin causes von Willebrand factor to bind the platelet receptor glycoprotein Ib, so when ristocetin is added to normal blood, it causes agglutination. In von Willebrand disease, abnormal agglutination occurs). While Haemophilia is treated by infusion of the deficient clotting factor, the treatment of von Willebrand includes administration of desamino-8-arginine vasopressin, which raises levels of von Willebrand factor.