Coagulopathy Associated with Liver Disease

The liver is responsible for producing coagulation factors and anticoagulant proteins. When the liver is damaged or functioning inadequately, the balance of hemostasis is disrupted, resulting in both an increased risk of bleeding and thrombosis.

Causes include:

Reduced synthesis of coagulation factors

Impaired absorption of vitamin K

Deficiency of anticoagulant proteins (Protein C, Protein S)

Splenic sequestration of platelets (hypersplenism), leading to thrombocytopenia

Clinical manifestations: Skin bruises, nasal and gingival bleeding, gastrointestinal hemorrhages, heavy menstrual bleeding, and increased risk of bleeding during surgery.

Diagnosis: Prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT).

Treatment (depending on cause and severity):

Vitamin K administration

Fresh frozen plasma (FFP)

Platelet transfusion in cases of thrombocytopenia

Cryoprecipitate for fibrinogen or factor VIII deficiency