By Michael Tarantino, MD, Medical Director of the Bleeding & Clotting Disorders Institute
Blood flow in the human body is designed to be fluid and uninterrupted with the intent of delivering oxygen and other nutrients to all tissues. In the healthy state, blood cells and blood vessel linings have smooth surfaces to promote this. When a blood vessel is injured, the harmonious flow of blood is disturbed and changes in the blood cells and blood vessels help limit blood loss, form a clot at the site of injury, and restore streamline flow. One can imagine that the natural process of stopping bleeding is a complex process requiring a balance between preventing bleeding and preventing excessive clotting. Many individuals have disorders of this balance and sometimes end up with excessive bleeding or clotting.
Clotting Disorders
Development of a blood clot is called thrombosis. The vascular system includes both the venous system (veins that deliver blood from tissues to the heart) and the arterial system (system that delivers blood from the heart to tissues). Thrombotic episodes may occur in either system. Symptoms relate to the part of the vascular system where they occur, the extent of the clot, and whether the clot breaks off and travels to another part of the body (embolize).
Clotting disorders describes conditions where there is an increased tendency for excessive clotting. These disorders may be inherited conditions and include:
- Prothrombin 20210A mutations
- Anti-Thrombin Deficiency
- Factor V Leiden
- Protein C Deficiency
- Protein S Deficiency
- Hyperhomocysteinemia
Some conditions, like anti-phospholipid syndrome, are acquired and usually become more common with increasing age. Common medical conditions may increase a person’s risk for excessive clotting including: obesity, smoking cigarettes, high blood pressure, diabetes (type 1 or type 2), high blood cholesterol, and use of oral contraceptives.
There are different terms that further define thrombotic episodes, such as deep vein thrombosis (DVT) or peripheral vascular disease. For some, we are now able to determine underlying causes for an increased risk of excessive blood clotting, but we are not able to make this determination in all cases. This means there is still more to be understood about why some persons have thrombophilia.
Thrombosis is a very common medical problem, and approximately two million people experience a DVT each year in the United States. Additionally, nearly half of patients with deep vein clots experience long-term health consequences that adversely affect their quality of life and require millions of dollars of treatment.
What is Thrombophilia?
Thrombophilia is the increased tendency of thrombosis or blood clots. Some forms of thrombophilia are caused by an abnormality or deficiency of a natural blood factor that regulates clotting.
Both children and adults can have thrombophilia, and it can occur in males and females. Thrombophilia affects a large number of people around the world. Recent research shows that these disorders contribute significantly to morbidity and mortality in the United States. Each year, more than 600,000 Americans die from abnormal blood clots.
Treatment
People with thrombophilia may receive medications that affect the coagulation system. Some people with thrombophilia may be prescribed products, usually blood thinners, on a long-term or an intermittent basis, depending on the underlying cause of the thrombophilia.
Patients with thrombophilia should be seen by a multi-disciplinary team of medical professionals within one facility. Similar to hemophilia care and prevention services delivered through Hemophilia Treatment Centers (HTCs), integrated care may decrease the morbidity and mortality associated with thrombophilia.
Importance of Access to a Hemophilia Treatment Center
As a nonprofit, multi-disciplinary evaluation, treatment, and research facility, the Bleeding & Clotting Disorders Institute (BCDI) is the medical home for children and adults with bleeding and clotting disorders providing specialized healthcare services, education, advocacy, and state-of-the-art research. The BCDI medical staff recognizes that personalized healthcare provided by caring, experienced professionals is paramount to achieving the highest quality of life. Combined, our team has over 250 years of experience caring for adults and children with bleeding and clotting disorders.
BCDI understands challenges such as new relationships with the healthcare system, new treatments and therapies, and learning new terminology. Hemophilia Treatment Centers have been an excellent resource due to the staff’s understanding of unique needs associated with a bleeding or clotting disorder.
At BCDI, we deliver state-of-the art medical care and offer tremendous emotional support to patients and families. Our multi-disciplinary team of providers work together to make sure you receive the highest quality of care possible.
When to visit a Hematologist
If an individual is experiencing symptoms related to bleeding or excessive clotting issues, it is important to consult a board certified hematologist. Being Hematology Board Certified involves sub specialized training, a rigorous process of testing, and peer evaluation that is designed and administered by specialists in the specific area of medicine. This specialized knowledge allows assistance in arriving at diagnosis, on-going management of a disorder, and opportunities for patients to participate in funded programs or clinical research trials.
Referrals to BCDI come from physicians, hospitals, and self-referrals throughout the “downstate” Illinois area. BCDI collaborates with other health care providers for the coordination of care to minimize the need for travel and hospitalizations and to provide the best possible care for patients.
For more information, contact the Bleeding & Clotting Disorders Institute at (309) 692-5337, ilbcdi.org, info@ilbcdi.org, or facebook.com/ILBCDI. Office Hours: Monday-Friday 7:30am-4:30pm. BCDI is located at 9128 N. Lindbergh Drive, Peoria, IL 61615.
Michael D. Tarantino, MD, completed his residency in pediatrics at the University of Arizona Health Sciences Center in 1990. He is currently a professor of the Pediatrics and Medicine at the University of Illinois College of Medicine. He is a board-certified in Pediatric Hematology/Oncology and brings 25 years of experience caring for children and adults with bleeding and clotting disorders.