coagulopathic

Coagulopathic is an adjective describing a condition in which the blood's ability to coagulate is impaired. Coagulopathy can cause abnormal bleeding, prolonged oozing after injury, easy bruising, or, in severe cases, life-threatening hemorrhage.

Causes are broadly categorized as inherited or acquired. Inherited coagulopathies include deficiencies of coagulation factors (such as hemophilia A and B) and platelet or von Willebrand disease. Acquired coagulopathies arise from liver disease with reduced synthesis of clotting factors, vitamin K deficiency, anticoagulant therapy, disseminated intravascular coagulation, massive transfusion, sepsis, or alcohol-related coagulopathy.

Presentation varies with severity and location of bleeding. Minor mucosal bleeding, epistaxis, menorrhagia, or postoperative oozing are common; severe cases may involve intracranial or gastrointestinal hemorrhage.

Diagnosis relies on laboratory testing, including prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet count, and fibrinogen level. Additional testing may include mixing studies, specific factor assays, von Willebrand factor analysis, and D-dimer or fibrinogen degradation products when disseminated intravascular coagulation is suspected.

Management aims to treat the underlying cause and correct coagulopathy as needed. Interventions may include vitamin K for deficiency or warfarin reversal, fresh frozen plasma or prothrombin complex concentrates for multiple factor deficiencies, cryoprecipitate or fibrinogen concentrates for hypofibrinogenemia, platelet transfusion for severe thrombocytopenia, and specific factor concentrates or desmopressin for certain disorders. Antifibrinolytics and meticulous supportive care are used as appropriate; reversal of anticoagulants should be considered in bleeding or prior procedures.

Prognosis depends on the cause and the rapidity of treatment. Many inherited coagulopathies are chronic conditions requiring ongoing management, while acquired coagulopathies may improve with correction of the underlying issue or cessation of anticoagulants.