Thrombotic/Thromboembolic Disorder

Thrombotic/Thromboembolic Disorder General Information

Thrombotic/Thromboembolic Disorder is the general definition for a category of blood diseases such as Thrombotic thrombocytopenic purpura, thrombotic stroke and Thrombophilia, which can be inherited or acquired. Thrombocytopenic purpura also known as Moschowitz disease (abbreviated as TTP) is a very rare blood coagulation disorder which leads to the formation of blood clots which usually appear in the small blood vessels all over the body. In the majority of the cases this disease appears as a consequence of the deficiency of the ADAMTS13 enzyme or as a consequence of the lack of this enzyme.  Due to the formation of the blood clots the blood flow is reduced and this leads to cellular injuries which will end in organ damage.

Thrombotic strokes appear due to the blood clots which develop in the arteries which supply the brain with blood. This type of Thrombotic/Thromboembolic Disorder is often seen in elderly persons which usually have high cholesterol levels or atherosclerosis (a disease in which on the walls of the blood vessels appear deposits of lipids and fats). In a thrombotic stroke there is usually a blood clot which blocks the blood flow to one of the parts of brain; this leads to the insufficient irrigation of that part and to the death of the cells in that area. Patients with Thrombophilia present an increased risk of developing unusual blood clots, as a result of the abnormalities in their blood system. The hereditary defects in the blood system are known to lead to the appearance of dangerous blood clots.

Thrombotic/Thromboembolic Disorder Symptoms

It is well known the fact that any medical disorder (including Thrombotic/Thromboembolic Disorder) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from Thrombotic/Thromboembolic Disorder or from any other medical disorder. Here, you will find a list of the most common symptoms that a person who suffers from such a medical condition may experience.

The patients who are suffering from thrombotic thrombocytopenic purpura may experience neurological symptoms (such as altered mental status, stroke, weird behavior, confusion, nausea, vomiting and headaches), fever, and in some cases kidney failure. Some of the patients can develop thrombocytopenia (meaning low platelet count) which can lead to purpura; others may develop microangiopathic hemolytic anemia. Patients who are at risk of developing thrombotic strokes may experience the following symptoms before the stroke: trouble standing and walking, dizziness, loss of the balance, problems with coordination, numbness of the face, confusion, speaking and / or understanding problems. Patients may also experience weakness of the arms or legs, which is more acute in one part of the body, seeing problems, and so on.

The patients who are suffering form Thrombophilia (a type of Thrombotic/Thromboembolic Disorder) usually develop two conditions which are known as venous thromboembolism (VTE): deep vein thrombosis (also abbreviated DVT, which usually appears in the legs leading to swelling, redness and pain of the legs) and pulmonary embolism (PE).

Thrombotic/Thromboembolic Disorder Treatment

Thrombocytopenic purpura (TTP), the first of the Thrombotic/Thromboembolic Disorders listed above, is in most of the cases caused by spontaneous aggregation of the platelets which leads to coagulation in the smallest blood vessels from the body.  There are two types of TTP referred to as idiopathic and secondary. The first type appears due to the inhibition of the ADAMTS13 enzyme, inhibition determined by the antibodies. The second type’s appearance is not fully understood, but doctors state that the factors which can lead to this disease are cancer, pregnancy, bone marrow transplantation, HIV infection and also treatment with medications such as immunosupprenssants ( like Cyclosporines and Interferon – α) and platelet aggregation inhibitors (like Clopidogrel or Ticlopidine).

The treatment which is used in the case of patients who are suffering from this disease involves plasmapheresis - a transfusion. This transfusion consists in the removal of the patient’s blood plasma during an apheresis process and in the replacement of the plasma with a new one from a donor). This process must be repeated for several days, until the entire blood plasma is replaced with a healthy one.

Individuals who are more likely to develop a thrombotic stroke, the second Thrombotic/Thromboembolic Disorder listed above, are: elderly patients, persons with high levels of cholesterol, persons who are suffering of blood coagulation problems, and so on. The treatment is based on the use of a tissue plasminogen activator (also abbreviated T-PA). The plasminogen activator is helpful in dissolving the clots which develop in the coronary arteries (and can lead to acute heart attack). The initial treatment of this type of stroke is based on Aspirin, anticoagulants, heparin, Coumadin and thrombolytics (also known as clot dissolvers). In the cases in which the carotid artery (situated in the neck area) is narrowed, the treatment is usually based on a surgery called carotid endarterecomy which helps to reduce the risk of the stroke development. 

The last Thrombotic/Thromboembolic Disorder on the list, Thrombophilia may develop due to prothrombin mutation, high homocysteine levels (which are caused by a mutation in the MTHFR gene or to vitamin deficiencies B6, B12 or folic acid), antiphospholid antibodies present in the organism (such as anti-cardiolipin antibodies and lupus anticoagulants). The rare forms of this disease may be caused by the plasminogen and fibrinolysis disorders, protein C and S deficiencies, antithrombin III deficiency and paroxysmal nocturnal hemoglobinuria. There is not a specific treatment for many Thrombophilias, but if a patient has recurrent thrombosis this condition may be prevented through a long term treatment with anticoagulants - at a doctor’s recommendation.

There are many blood-thinning drugs which can be used to treat this Thrombotic/Thromboembolic Disorder, but unfortunately they have many side effects and can not be recommended in a long-term treatment. Aspirin is not advisable for persons who are suffering from this Thrombotic/Thromboembolic Disorder, because the beneficial blood thinning properties of this drug are not effective in the prothrombin mutation or the V Leiden factor.