PB0572 - Specific bleeding symptoms for detection of bleeding disorders

Background: The etiology of bleeding tendencies is often remained unidentifiable. Some reports suggest that only 30% of patients with bleeding symptoms are diagnosed as bleeding disorders, and many of them are classified as Bleeding Disorders with Unknown Causes (BDUC).

Aims: To assess the association between bleeding symptoms and diagnosis of bleeding disorders.

Methods: A retrospective single-center study was conducted for patients with bleeding symptoms at Ogikubo Hospital, Tokyo, Japan, since Jan. 2019 to May 2023, with permission of local ethical committee. We used the ISTH/SSC bleeding assessment tool (ISTH-BAT) to assess bleeding patterns and severity, where normal score was set as < 6 for females and < 4 for males and children in total, and < 1 for each symptom category.

Results: A total of 54 patients were referred, including 45 (83.3%) of females (Table 1). Abnormal BAT score was observed in 12 (22.2%), and median (range) ISTH-BAT score was 3 (2-16) in male and 2 (0-22) in females, respectively. We diagnosed 14 (26%) patients as bleeding disorders, including 6 with VWD or low VWF, 3 with FVIII or FIX deficiencies, 2 with platelet disorders, 2 with FVII or FX deficiencies, and 1 with vascular abnormalities. Four (7.4%) were classified as BDUC. Patients diagnosed with bleeding disorders or BDUC showed higher BAT scores than those without bleeding disorders (5.5 vs. 2, p< 0.05), and especially, BDUC patients had relatively higher scores. (Figure 1) Among the symptomatic categories of ISTH-BAT, scores of bleeding in skin, mucous, and muscles were significantly higher in the patients with bleeding disease or BDUC, whereas those of postpartum and menorrhagia were not different between them (Table 1)

Conclusion(s): A higher BAT score was associated with bleeding disorders. Bleedings in skin/mucous seem to be specific to detect bleeding disorders. Further research using a larger population with more precise diagnostic tests is warranted.