Idiopathic Haemolacria: A Rare Case Report

Abstract

Crying with bloody tear, called haemolacria is a very rare condition in medical practice. There are many conditions such as idiopathic thrombocytopenic purpura, trauma (accidental or induced), factors deficiencies, infections (Epstein Barr virus or bacterial), tumours (malignant melanoma or haemangioma), conjunctival telangiectasia, Rendu-Oslar-Weber disease related to haemolacria. But idiopathic haemolacria may occur in some cases. In our case report, a 17-year-old girl presented with idiopathic bilateral haemolacria and gum bleeding associated with pseudoseizure and psychogenic hyperventilation who was treated and well responded to adequate counselling and Amitriptyline.
 J MEDICINE JUL 2019; 20 (2) : 106-108

Tears of blood – a female adolescent with essential idiopathic bilateral haemolacria: case report and brief review

“…After performing an extensive search of the literature, we were able to find 23 cases of idiopathic bilateral hemolacria. 3–6,11,12 The median age of onset is 12 years. The duration of symptoms were in the range of one day to five years and was accompanied by epistaxis most commonly; other associated symptoms were giddiness, headache, yellowish discharge from the eyes, fever, twitching of the extremities, haematohidrosis and menorrhagia.…”

“…Although multiple management options in the form of high doses of vitamin C, intramuscular injection of vitamin K, oral amitriptyline and topical antibiotics have been tried in previous years, there is still no definite management protocol for essential idiopathic hemolacria. 4,11,13 In most of the cases of idiopathic haemolacria, regular follow-up of the patient and psychological support for the patient and family members are all needed.…”

“…Her nasolacrimal passage was fine and no pathology was found on radiological imaging. 17 15/F -3 months -2016 Pujari et al 12 16/F -1 month None/decrease in episodes over 6 months 2016 Sobol et al 18 11/F -3 days None/decrease in frequency over 14 months 2016 Palali et al 19 14/F -8 months None/reduced frequency over 1 year 2017 Bakhurji et al 4 4 months/F Yellowish discharge, flu-like illness 3 days Fusidic acid 1% eye drops/ resolved over 3-4 days 2018 James et al 20 22/M -2 episodes None/-2019 Acherjya et al 11 17/F Gum bleeding, twitching movement of body, shortness of breath Haemolacria after a scleral buckle infection and after a Lefort 1 surgery has also been reported. 8,9 However, our patient did not have any history of surgery in the past.…”