Dental Management of Patients with Bleeding Disorders
Blood Vessel Wall Abnormalities

Course Author(s): Sandra D'Amato-Palumbo, RDH, MPS

Blood Vessel Wall Abnormalities

Blood vessel wall abnormalities, or increased fragility of the blood vessels, are relatively common but do not usually cause a serious bleed. When evaluating the laboratory tests for this condition, one can expect a normal platelet count, bleeding time and coagulation times (PT and aPTT). Pathophysiologically, this condition manifests itself by observable extraoral and intraoral signs of hemorrhage: petechiae and ecchymosis are found in the skin or on the mucous membranes, particularly on the gingiva. Very rarely, significant hemorrhage may occur, particularly in the joints, muscles, and subperiosteal locations. Excessive bleeding may also take the form of menorrhagia (abnormal long and heavy menstrual periods), nosebleeds, gastrointestinal bleeding, or hematuria (abnormal presence of blood in the urine).5

Causes of Blood Vessel Wall Abnormalities5

  • Infections (i.e., septicemia, infective endocarditis, several forms of rickettsioses)
  • Drug reactions (i.e., hypersensitivity vasculitis)
  • Scurvy, Henoch-Schönlein purpura
  • Hereditary hemorrhagic conditions.