Blood Disorders

What are blood disorders?

Blood disorders are conditions that keep parts of your blood from doing their jobs:

• Your red blood cells carry oxygen throughout your body.
• Your white blood cells help protect your body from infection.
• Your platelets help your blood to clot so you don’t bleed more than normal.

Blood disorders may be cancerous or noncancerous. This article focuses on noncancerous blood disorders.

You may inherit a noncancerous blood disorder or develop one because you have an underlying condition that affects your blood.

Some blood disorders may not cause symptoms or require treatment. Others are chronic (lifelong) illnesses that require treatment but typically won’t affect how long you’ll live. Other blood disorders are serious illnesses that can be life-threatening.

Healthcare providers treat blood disorders by managing symptoms and treating any underlying conditions.

How do blood disorders affect my body?

In general, noncancerous blood disorders are conditions that affect your blood cells and platelets and cause issues that may:

• Increase your risk of blood clots. Factor V Leiden, an inherited blood disorder, is an example of a blood clotting disorder.
• Make you bleed more than normal because your blood doesn’t form blood clots. Inherited hemophilia is an example of a bleeding disorder.

What are common blood clotting disorders?

A blood clotting disorder affects your platelets or your clotting factors (coagulation factors). Clotting factors are proteins in your blood. Your platelets and clotting factors make blood clots, which control bleeding. Blood clotting disorders may be called a hypercoagulable state or thrombophilia. Blood clotting disorders include:

• Prothrombin gene mutation: This inherited disorder increases your risk of developing abnormal blood clots in your veins (deep vein thrombosis) and lungs (pulmonary embolism).
• Antiphospholipid syndrome: This rare autoimmune disorder, which often affects people who have lupus, can cause blood clots in several areas of your body.
• Protein S deficiency: Protein S is a natural anticoagulant in your blood. Anticoagulants prevent blood from clotting. Protein S helps keep other proteins from making too many blood clots. This is a rare inherited disorder.
• Protein C deficiency: Like protein S, protein C is a natural anticoagulant that protects you from developing too many blood clots.
• Antithrombin deficiency: This inherited disorder increases your risk of deep vein thrombosis.
• Paroxysmal nocturnal hemoglobinuria: This rare blood disorder happens when your immune system attacks your red blood cells, increasing your risk of blood clots.
• Disseminated intravascular coagulation (DIC): DIC is a rare blood clotting disorder that may cause uncontrollable bleeding or clotting.

Some people with blood clotting orders have an increased risk of stroke and heart attack. Call 911 if you think you’re having a pulmonary embolism because you have chest pain and difficulty breathing. Heart attack and stroke are other medical conditions that need emergency treatment.

What are common bleeding disorders?

Bleeding disorders happen when your blood doesn’t clot normally, causing you to bleed more than usual. Bleeding disorders include:

• Von Willebrand disease: This condition is the most common bleeding disorder in the U.S. Most people who have von Willebrand disease inherited a mutated gene from one of their biological parents. Some people develop this condition as a complication of certain cancers, autoimmune disorders, and heart and blood vessel diseases.
• Inherited hemophilia: This rare genetic condition may make you bleed more than usual. There are three types of hemophilia: Type A or classic hemophilia, Type B or Christmas disease and Type C (Rosenthal syndrome).
• Thrombocytopenia: This condition happens when you have a low platelet count. Immune thrombocytopenia (ITP) and thrombotic thrombocytopenic purpura (TTP) are examples of diseases that cause thrombocytopenia.
• Fibrinogen deficiency conditions: Fibrinogen is another protein that helps your blood clot.If you don’t have enough fibrinogen or your fibrinogen doesn’t work as it should, you may have abnormal bleeding or clotting issues.

What is the most common type of blood disorder?

Anemia represents the most common type of noncancerous blood disorder. The U.S. Centers for Disease Control and Prevention estimates about 3 million people in the U.S. have some type of anemia. Anemia happens when you don’t have enough healthy red blood cells. Some types of anemia are inherited, but people may also acquire or develop them.

Acquired anemias

• Pernicious anemia: Pernicious anemia, one of the causes of vitamin B12 deficiency, is an autoimmune condition that prevents your body from absorbing vitamin B12.
• Iron-deficiency anemia: As its name implies, iron-deficiency anemia happens when your body doesn’t have enough iron to make hemoglobin. Red blood cells need hemoglobin to carry oxygen throughout your body.
• Megaloblastic anemia: Megaloblastic anemia is a type of anemia that can happen when you don’t get enough vitamin B12 and/or vitamin B9 (folate).
• Aplastic anemia: This anemia happens when stem cells in your bone marrow don’t make enough blood cells.
• Autoimmune hemolytic anemia: In autoimmune hemolytic anemia, your immune system attacks your red blood cells.
• Macrocytic anemia: This anemia happens when your bone marrow makes unusually large red blood cells. Macrocytic anemia may be caused by myelodysplastic syndrome, low folate, low B12 vitamin, liver disease, alcohol use and certain medications.
• Normocytic anemia: In this type of anemia, you have fewer red blood cells than usual. There are many causes of normocytic anemia.

Inherited anemias

• Sickle cell anemia: Sickle cell anemia changes your red blood cells’ shape, turning round flexible discs into stiff and sticky sickle cells that block blood flow.
• Fanconi anemia: Fanconi anemia is a rare blood disorder. Anemia is one sign of Fanconi anemia.
• Diamond-Blackfan anemia: This inherited disorder keeps your bone marrow from making enough red blood cells.
• Thalassemia: In thalassemia, your body produces less hemoglobin, resulting in small red blood cells and anemia.

Other anemia types

Some types of anemia may be inherited but can also be acquired:

• Hemolytic anemia: In this anemia, your red blood cells break down or die faster than usual.
• Sideroblastic anemia: Sideroblastic anemia results from abnormal iron use during red blood cell development.
• Microcytic anemia: This anemia happens when your red blood cells don’t have enough hemoglobin so they’re smaller than usual. Microcytic anemia occurs with iron deficiency, thalassemia, sideroblastic anemia and in some cases of anemia of chronic disease.

What are common blood disorder symptoms?

Blood disorder symptoms depend on the specific blood disorder and its impact on your blood.

For example, most people with anemia have the following symptoms:

• Fatigue and weakness.
• Dizziness.
• Skin that’s paler than usual.
• Fast heartbeat (heart palpitations).
• Shortness of breath.

Common bleeding disorder symptoms

The most common symptom is excessive and continuous bleeding. You may want to talk to your healthcare provider if you have any of the following symptoms:

• Nosebleeds: These are nosebleeds that last longer than 10 minutes and happen five or more times a year.
• Excessive bleeding: Cuts or injuries that bleed longer than 10 minutes.
• Internal bleeding: This may cause joint pain.
• Bruises: Bruising that happens for no apparent reason or after a minor injury.
• Post-surgery bleeding: Heavy bleeding after any kind of surgery, including dental surgery.
• Heavy periods (menstrual bleeding): This is bleeding that’s so heavy you need to change your pad or tampon every hour or have bleeding that lasts longer than seven days.
• Heavy bleeding after childbirth or miscarriage.
• Blood in poop (stool): Blood in your poop or bleeding after pooping may be a symptom of other medical conditions. Talk to your healthcare provider if you have blood in your poop.
• Blood in pee (hematuria): Talk to your healthcare provider if you notice blood when you pee, particularly if you have an urgent need to pee and there’s blood in your pee.

Common blood clotting disorder symptoms

Blood clotting disorders increase your risk of developing blood clots in your veins, lungs and other areas of your body. People with blood clotting disorders may have the following symptoms:

• Swelling, tenderness and pain in your leg can mean you have deep vein thrombosis.
• Chest pain with shortness of breath can mean a possible pulmonary embolism.
• Heart attack.
• Stroke.

What is the most common cause of blood disorders?

There’s no single cause for blood disorders. Some people inherit blood disorders. Other blood disorders happen because people develop a condition that affects their blood.

How do healthcare providers diagnose blood disorders?

Healthcare providers will do physical examinations, ask you about your medical history and your symptoms. They may do several blood tests.

Red blood cell tests

Red blood cells carry oxygen from your lungs to your body’s tissues. Your tissues produce energy with the oxygen and release carbon dioxide. Your red blood cells take the carbon dioxide waste to your lungs for you to exhale.

Providers will take blood samples to evaluate your red blood cell count and your red blood cell components or parts. They may do tests to see what your red blood cells look like under a microscope. Red blood cell tests may include:

• Hemoglobin test: Hemoglobin is the main component of red blood cells. The test is often used to detect anemia.
• Hematocrit test: This test measures the percentage of red blood cells in your blood.
• Reticulocyte count: Reticulocytes are immature red blood cells. This test checks to see if your bone marrow is producing enough healthy red blood cells.

White blood cell tests

White blood cells represent about 1% of your blood. They protect your body against infection. Abnormal white blood cell levels may be signs of several medical conditions.

For example, a high white blood cell count (leukocytosis) may mean you have an infection, inflammation or cancer. A low white blood cell count (leukopenia) may be a sign of conditions ranging from vitamin deficiencies to cancer.

There are three kinds of white blood cells — granulocytes, monocytes and lymphocytes. Granulocytes include three sub-types of white blood cells — eosinophils, basophils and neutrophils. Your healthcare provider may do a complete blood count (CBC) with differential to evaluate each white blood cell type:

• Eosinophils: Eosinophils protect your body from infections. Blood tests may show high eosinophil levels (eosinophilia). Eosinophilia may be a sign of underlying medical conditions.
• Basophils: Basophils protect your body against allergens and other intruders. Basophilia happens when your body produces too many basophils. A high basophil count may be a sign of certain blood cancers.
• Neutrophils: Neutrophils are the most common white blood cell type. Neutrophils are the first responders to fight infection. Low neutrophil counts are neutropenia. Neutropenia may increase your risk of serious infection.
• Monocytes:These white blood cells find and destroy germs. High levels of monocytes (monocytosis) may be a sign of infectious diseases.
• Lymphocytes: There are two main types of lymphocytes: T lymphocytes (T cells) manage your body’s immune system response. They attack and destroy infected cells and other intruders; B lymphocytes (B cells) make antibodies. Antibodies are proteins that target viruses, bacteria and other foreign invaders.

Platelet tests

Platelets, also called thrombocytes, help make blood clots and control bleeding. Tests to evaluate your platelet health may include:

• Platelet count: This test measures the number of platelets in your blood.
• Mean platelet volume (MPV) test: This blood test measures the average size of your platelets.
• Peripheral blood smear (PBS): Your provider may use this test to examine your platelets under a microscope. (They also use this test to examine your white and red blood cells.)

How do healthcare providers treat blood disorders?

In general, healthcare providers focus on identifying and treating underlying conditions that cause blood disorders. They also treat blood disorder symptoms. Treatments may include:

• Watchful waiting: Some blood disorders don’t cause noticeable symptoms. If that’s your situation, your provider will monitor your overall health, paying close attention to any new signs or symptoms that you’re developing a blood disorder.
• Blood and platelet transfusions:Providers may use blood transfusions to boost red blood cell levels for people with severe forms of anemia. They may use platelet transfusions to help with blood clotting issues.
• Anticoagulants: These medications help with blood clotting disorders by keeping your blood from clotting too easily.
• Growth factor supplementation: This treatment stimulates your bone marrow so it makes additional red and white blood cells. Erythropoietin-stimulating agents (ESA) are examples of growth factor supplements.
• Corticosteroids:This treatment suppresses your immune system. Providers may use steroids to treat autoimmune hemolytic anemia.

These treatments have different side effects. Ask your provider about treatment side effects. They’ll help you manage them.

Can people prevent noncancerous blood disorders?

That depends on the specific disorder. Some blood disorders are inherited, which means you can’t prevent them. Others are caused by underlying conditions that you may or may not be able to prevent. While you can’t always prevent blood disorders, there are steps you can take to reduce your risk of developing complications.

How can I reduce my risk of developing these disorders?

Taking care of your overall health may reduce your risk of developing conditions that cause blood disorders. Suggestions include:

• Eat a healthy diet rich in vitamins and minerals:This includes foods with iron such as eggs, turkey, lean beef and organ meats like kidney and liver. Legumes, including black beans, leafy green vegetables and brown rice, are other foods that help increase your iron intake.
• Stay active:Regular exercise helps support your immune system.
• Maintain a healthy weight:Talk to a healthcare provider about attaining and maintaining a weight that’s right for you.
• Take steps to prevent infection:Be sure to wash your hands well and often. Talk with your provider about the seasonal flu shot (vaccine) and any other vaccines you should consider.
• Get regular checkups: If you have a blood disorder or you may be at risk of developing a blood disorder, your provider will schedule regular appointments to check your overall health. They may do blood tests.

What is the prognosis or expected outcome for noncancerous blood disorders?

Noncancerous blood disorders vary widely. For example, many people with blood clotting disorders may have normal lifespans, but may require medication and treatment for the rest of their lives. But some blood disorders, like sickle cell anemia, may be life-threatening. People’s prognoses also depend on factors such as their age and overall health. If you have a blood disorder, ask your healthcare provider what you can expect.

How do live with a blood disorder?

Blood disorders may change your way of life. But there are things you can do to maintain your quality of life. For example:

• Educate your family and friends: Explain how your blood disorder may affect you. That way, they’ll understand why you may not be able to do certain activities and they’ll know what to do if you have a medical emergency.
• Consider wearing a medical alert bracelet: In the event of severe illness or injury, wearing this bracelet tells healthcare providers about your condition so they can give you the care you need.
• Eat an iron-rich diet: Eating a healthy diet can help anyone living with a blood disorder.
• Treat any bleeding right away: If you have a bleeding disorder, your healthcare provider may prescribe medication (factor) to help your blood clot. People with bleeding disorders should treat bleeding quickly by taking medication as prescribed.
• Reduce your risk of injury: If you have a bleeding disorder, avoid contact sports that may increase your risk of falling or being hit. Always wear your seatbelt. If you ride a bike, wear a helmet.

When should I see my healthcare provider?

Contact your healthcare provider if you notice changes in your body that may be signs your condition is getting worse.

When should I go to the emergency room?

Some noncancerous blood disorders may cause medical emergencies. People with blood clotting disorders have an increased risk of blood clots that may cause pulmonary embolism, heart attack and stroke. If you have a blood clotting disorder and have chest pain, call 911.

If you have a bleeding disorder and you’re injured, you may have trouble controlling your bleeding. If your prescribed medication doesn’t slow your blood flow, go to the emergency room.

What questions should I ask my healthcare provider?

There are many kinds of noncancerous blood disorders. If you’ve been diagnosed with one of these disorders, you may want to ask your provider the following questions:

• What kind of blood disorder do I have?
• How will this condition affect me?
• Is this condition life-threatening?
• What are treatments?
• What are treatment side effects?
• Will treatment cure me?
• If not, will I always need to take medication?
• How did I develop this blood disorder?
• If I inherited this disorder, should my close family members have genetic testing?

A note from Cleveland Clinic

Noncancerous blood disorders are conditions that keep your blood from doing its job. Your blood may not make blood clots to keep you from bleeding more than normal. Your blood may make clots too easily, increasing your risk of blood clots that could cause a stroke or heart attack. Often, these conditions are chronic (long-term) and require lifelong medical care. With treatment, most people with noncancerous blood disorders have a normal lifespan and good quality of life.