Primer to Bleeding Disorders

A bleeding disorder, also known as a bleeding diathesis or bleeding tendency, is an inherited or acquired disorder affecting primary or secondary hemostasis. This chapter will first describe common systemic illnesses often associated with bleeding diatheses, relevant pathophysiology, and clinical pearls. We then focus on the diagnostic approach to a patient with unexplained bleeding, importantly considering clinical history, family history, and physical exam. If a bleeding disorder is suspected, a nuanced laboratory evaluation should be performed, and the utility of specific tests is described in detail here as well as the laboratory findings for hereditary and acquired bleeding disorders. Further, these disorders are characterized by their underlying genetic aberrations, pathophysiology, and clinical presentation. Particular attention is paid to the subtypes of von Willebrand disease, hemophilia, factor deficiencies, and qualitative platelet disorders. Lastly, the management of specific bleeding disorders is addressed by treatment type and clinical entity.