Patient Information Resource:
Benign Hematologic (Blood) DisordersA collaborative project of the Arizona Telemedicine Program, the Arizona Health Sciences Library and the Arizona Cancer Center.
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Blood Vessel Abnormalities
When blood vessels become weakened, bleeding occurs more easily. Vessels may be weakened by inflammation, malformation, or disease of the blood vessel’s supportive tissue. The following are examples of conditions that may cause bleeding.
A. Scurvy
Scurvy is a deficiency in vitamin C, usually due to poor diet. Vitamin C is necessary in forming the blood vessel’s chief supportive tissue, collagen. Therefore, without sufficient vitamin C, the blood vessels are weakened, and bleeding occurs more easily. Symptoms of scurvy include bleeding of the gums and bruising. Scurvy is most often caused by insufficient vitamin C in the diet, although it may also be the result of megaloblastic anemia. Depending on the cause, vitamin C supplements are administered or the anemia is treated (please see Anemia).
B. Henoch-Schönlein Disease (Anaphylactoid or Allergic Purpura)
Henoch-Schönlein purpura, or HSP, is an inflammation of blood vessel walls (aseptic vasculitis). It is associated with joint pain, abdominal symptoms, and kidney involvement. Its chief symptom is purpura, a pinkish to reddish-brown raised spot on the skin which begins with an itching feeling. HSP occurs most often in children, who usually notice joint and abdominal pain before purpura form. However, in adults, purpura is usually the first symptom. The characteristic purpura is painless and often occurs on the arms, legs, and buttocks. Other symptoms include bruising, abdominal pain, apathy, headache, seizures, blood in the stool, and arthritic pain in the joints. HSP may be triggered by infection (hepatitis B; ß-hemolytic Streptococcus, or “strep throat”; cytomegalovirus; Epstein-Barr virus), medications (penicillin, sulfa drugs such as Bactrim, phenytoin [Dilantin], iodine, drugs such as cimetidine and Tagamet, allopurinals such as Zyloprim), certain chemicals or insecticides, systemic autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus (discussed below), cancer, and food products (dyes, preservatives). Treatment focuses on minimizing bleeding and may involve administration of steroids. The disorder usually ends on its own after 4 to 6 weeks, although relapses are common.
C. Systemic Lupus Erythematosus (SLE)
SLE is a systemic autoimmune disease that may affect blood vessel connective tissue, producing inflammation of the blood vessel wall. In addition to increased bleeding, other SLE symptoms may be present. These include sensitivity to light, mouth sores, arthritis, seizures, anemia, skin rashes, nosebleed, and abdominal pain. It is diagnosed by patient history, physical examination for symptoms, and laboratory testing. Treatment should target the underlying disease. Possible options for treatment are plasmapheresis and medications such as corticosteroids such as Celestone, Betamethasone, Cortone and Cortisone, cyclophosphamide and azathioprine. It is often suggested that patients avoid aspirin, since it may lead to increased bleeding. Other connective tissue diseases, such as rheumatoid arthritis, may result in a similar condition. More information on systemic lupus erythematosus.
D. Other Factors
In addition to these disorders, factors that may cause bleeding and bruising include infection, corticosteroid therapy, and Cushing’s syndrome. Senile purpura is another condition with bleeding symptoms. It primarily affects elderly patients, and its symptoms are easy bruising, bleeding, and red spots on the skin (purpura).
GENERAL DISCLAIMER: This web site and its contents are designed for educational purposes only. This web site does not render medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider.
Updated: October 30, 2000