Persistent, prolonged bleeding is a common sign of defective blood clotting. However, the exact cause of this can vary from person to person. Two of the most common disorders associated with this problem are idiopathic thrombocytopenic purpura (ITP) and hemophilia.
Although both blood disorders share some similar symptoms, the two are much more different than alike. So what is the difference exactly?
Idiopathic Thrombocytopenic Purpura
ITP is an autoimmune disease in which the body produces antibodies that bind themselves to blood platelets. The immune system then destroys these platelets by mistake, resulting in a low platelet count. Platelets are tiny cells that clump together to form a blood clot, so a low platelet count means clotting is defective.
ITP is not genetic but instead develops over time. Children aged two to four are at risk of developing a temporary case of ITP following a viral infection, such as the flu or mumps. For adults, especially women, ITP is often chronic. This condition is triggered by a number of different factors such as certain drugs, an overactive spleen (which might require surgery to remove), or another underlying illness, such as HIV, lupus, or leukemia.
Although the most recognizable sign of ITP is a rash of small red or purple spots that occurs from bleeding under the skin, other symptoms include spontaneous nosebleeds, heavy menstrual cycles, and blood in urine or stools. Some cases, however, are asymptomatic.
Unlike ITP, hemophilia is not an autoimmune disorder, nor is clotting impaired due a low platelet count with it. Instead, hemophilia is an X-linked hereditary condition. Clotting deficiency is due to missing blood factor proteins.
For example, in hemophilia A, the more common type of the disorder, factor VIII is absent or defective, while in hemophilia B, factor IX is the missing or abnormal protein. It takes a blood test to determine the type of hemophilia a person has and its severity, but both are more likely to occur in males, even though females are primary carriers of the genetic mutation.
Similar to ITP, excessive bruising and bleeding are symptoms of hemophilia. Internal bleeding is a possible complication for both ITP and hemophilia, but while it is rarer in ITP, internal bleeding, such as in the joints, is a common occurrence with hemophilia.
However, while ITP develops later in life, hemophilia symptoms can manifest at birth. Prolonged bleeding following a circumcision in newborn males is often one of the earliest signs, as is frequent bruising and bleeding within the first year of life. Due to these early signs, hemophilia can be diagnosed at a young age. If the parents have a known history of the disease, they can even choose to have prenatal diagnostic testing done on the fetus as early as 12 weeks.