Re: nosebleeds = prolonged PTT or thrombocytopenia

[Guest guest]

Gene, you're right about the PTT and nosebleeds (aka epistaxis) -

patients on coumadin (blood thinner) also have prolonged PTTs and

nosebleeds.

However, bleeding problems can also be due to low platelets

(thrombocytopenia), usually <50 (thousand), and although low

platelets are not part of the (Mayo?) Model of Endstage Liver Disease

(MELD) score, can be a sign of worsening ESLD.

Regarding treatment if someone is having bleeding problems from

prolonged PTT Vitamin K (in ADEK i.e. vit. A + D + E + K - the fat-

soluable vitamins) can help make new clotting factors 2, 7, 9, and 11

but if the bleeding is due to low platelets one might require a

platelet transfusion. Also severe nosebleeds, or ones that don't stop

with simple direct pressure - can be treated in the ER by ENT docs w.

special nasal 'tampons' or posterior nasal packing. Severe nosebleeds

are a medical emergency not only because of ongoing hemorrhage but

also because of the potential for loss of airway i.e. choking on

blood. Let's hope none of us ever experiences this!

-Stefan

>

> > Does any one have nosebleeds.

>

> Very common symptom of PSC resulting from prolonged prothrombin

time

> (the time it takes for blood to clot). The liver makes the enzymes

> necessary for clotting and, when liver function is impaired, Pro

Time

> increases. It can also increase due to malabsorption of vitamin K

by

> the intestines, which many of us PSC folk have trouble with, too.

I

> take Vitamin K supplements and eat lots of bananas. More info

here:

> http://my.webmd.com/hw/health_guide_atoz/hw203083.asp

>

> - Gene A.