Endothelium, Platelets, and Coagulation Factors as the Three Vital Components for Diagnosing Bleeding Disorders: A Simplified Perspective with Clinical Relevance

Abstract

Bleeding disorders are a major group of hematological disorders, which are highly prevalent in the world. Excessive bleeding can result in serious consequences including hypoperfusion and cardiac arrest. The body has its selfmechanism to control excessive bleeding which is termed hemostasis. Hemostasis is achieved in two major steps, the formation of the primary and secondary hemostatic plugs. Endothelium, platelets, and coagulation factors are three components involved in hemostasis. Endothelium and platelets have a major role in forming the primary hemostatic plug. Consequently, the first step in investigating a bleeding disorder is platelet count. Despite normal platelet count, abnormality in the primary hemostatic plug may arise due to functional defects of the platelets including adhesion, activation, and aggregation. Von Willebrand disease (VWD) is an endothelial defect and the most prevalent inherited defect in coagulation. Abnormalities in the secondary hemostatic plug are largely due to coagulation factor deficiencies, and, to a lesser extent, the presence of inhibitors. Techniques involving viscoelastics have been aiding in rapid diagnosis and are useful in point-of-care testing. This article discusses the investigation of bleeding disorders from the perspective of the endothelium, platelet, and coagulation factor physiology. These three components should be properly investigated to achieve the definitive diagnosis of bleeding disorders.

Application of Biomedical Microspheres in Wound Healing

“…After the skin injury, the hemostatic phase begins immediately. This phase mainly involves vasoconstriction and coagulation waterfall-like reaction to initiate hemostasis [ 18 ]. Platelets are main contributors in the process of the hemostasis and coagulation.…”

Coagulation measures after cardiac arrest (CMACA)

“…Nevertheless, coagulofibrinolytic changes in PCAS patients treated with TTM are not fully understood. Endothelium, platelets, and coagulation factors are known as important components in the diagnosis of bleeding disorders and thus should be further studied in PCAS patients treated with TTM [16]. When an ischemic cardiovascular event occurs, breakdown of insulin-like growth factor binding protein occurs, increasing the production of CT-IGFBP-4.…”

Prevalence of Thrombocytopenia in Women during Third Trimester of Pregnancy

“…Hemarthrosis as well as muscular hematomas are usually not evident in cases of primary hemostatic abnormalities. 4,5 Most frequent causes of thrombocytopenia among pregnant females include gestational thrombocytopenia, infections and preeclampsia complicated by "Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome". 6,7 The gestational thrombocytopenia can be classified into three categories i.e.…”