Suman Rao, MD, MEDICAL ONCOLOGIST, WITH A PATIENT AT THE HARRY AND JEANETTE WEINBERG CANCER INSTITUTE AT MEDSTAR FRANKLIN SQUARE.
Benign hematologic disorders are inherited blood conditions and are usually managed with medication and lifestyle changes. At MedStar Health, our board-certified hematologists treat bleeding disorders, including:
- Anemia, a condition wherein the body does not produce enough red blood cells. After determining why, your doctor can recommend several different treatment options.
- Idiopathic TP (ITP), where your blood does not clot and you bruise very easily. You may need to avoid certain medications; one of our specialists can help design a treatment plan for you.
- Hemophilia, a condition in which the blood does not clot properly. Hemophilia is a genetic blood disease that is usually passed from mothers (who do not have symptoms of the disorder) to sons.
- Inherited enzyme disorders, in which proteins in the blood are missing and too many lipids (fats) build up in the blood. Examples of enzyme disorders include Gaucher's disease and Fabry's disease.
Blood disorders are serious illnesses that require rigorous medical care. They are not caused by uncontrolled cell growth, like cancer, but do require careful and serious medical attention. The blood disorders we treat include:
- Myelofibrosis, a condition that causes the bone marrow to thicken and scar, which prevents it from producing enough red blood cells. Red blood cells carry oxygen throughout the body and are a key component for a healthy circulatory system
- Myelodysplastic syndromes, which affect the bone marrow and its capacity to make different blood components. Individual syndromes affect the red blood cells, white blood cells, or platelets
- Polycythemia, which results from the overproduction of blood components (red blood cells, white blood cells, and platelets)
- Essential thrombocytosis, which reduces the blood's clotting abilities because there are not enough platelets. There are two types of thrombosis, one acute (which affects mostly children and disappears in a few months) and one chronic (which occurs in adults and becomes a permanent condition)
These disorders are treated by the physicians at MedStar Health and include:
Immune thrombocytopenic purpura, a condition wherein platelet- (thrombocyte-) count is low, making it difficult for blood to clot. Two kinds exist
- Acute immune thrombocytopenic purpura, which usually occurs in children after a virus, and generally goes away on its own after about six months.
- Chronic immune thrombocytopenic purpura, which usually occurs in adults, and lasts more than six months.
- Cuts that do not clot after an extended period of time
- Bloody gums
- Bloody urine or bowel movements
- Tiny, flat blood spots under the skin
In some cases, no treatment may be necessary beyond careful monitoring of platelet levels in the blood. In other cases, medication may be necessary. In rare cases, it may be necessary to remove the spleen, the organ that cleans blood.
Hypercoagulable disorders cause the body to create plugs (normally used to stop bleeding until a cut is healed) where they are not needed, essentially blocking healthy blood vessels. Symptoms of hypercoagulable disorders include:
- Deep vein thrombosis (blood clots in the veins of the lower leg)
- Pain where clot has occurred
- Swelling where clot has occurred
- Heart attack or stroke
- Shortness of breath
- Chest pain
- Blood clots in unusual places
Hypercoagulable disorders are usually treated with a course of anticoagulation medications. The combination of medications prescribed depends on the cause of the hypercoagulation, as well as other factors.
Hemophilia and other bleeding disorders are caused when the blood is not able to clot and stop bleeding as quickly as it should. Many types of hemophilia exist, each caused when a specific clotting factor is not able to do its job. Common symptoms of hemophilia and other bleeding disorders include:
- Spontaneous bleeding
- Lots of deep or big bruises
- Unexplained bruising, bleeding, or nosebleeds
- Blood in urine or bowel movements
- Swelling, pain, and tightness in joints (caused by internal bleeding)
- Bleeding for a long time from cuts, after surgery, or having a tooth out
- Sudden swelling, pain and warmth in shoulders, elbows, hips, knees, or arm and leg muscles
- Very painful headache that lasts a long time
- Double vision
- Easily exhaustible
- Neck pain
The treatment of hemophilia and other bleeding disorders depends on the type and severity of the hemophilia or bleeding disorder. In some mild cases, a hormone injection can help the body make more the necessary clotting factors. In more serious cases, an infusion of clotting factor, usually from donated blood, is necessary to stop bleeding. Regular, preventative infusions of clotting factor may also be needed.