Bleeding Disorder & Platelet Specialists in Melbourne
Easy bruising or prolonged bleeding can arise from problems with platelets, clotting proteins, blood vessels, medications or other medical conditions. Some inherited bleeding disorders are present from childhood, while others become apparent only after surgery, dental work, pregnancy or a new medication. Low platelet counts are also common and range from mild, incidental findings to conditions requiring urgent treatment.
Von Willebrand disease is the most common inherited bleeding disorder. Von Willebrand factor helps platelets attach at sites of blood vessel injury and also carries clotting factor VIII. Symptoms can include frequent nosebleeds, easy bruising, heavy menstrual bleeding, prolonged bleeding after dental work or surgery and postpartum bleeding. Diagnosis can be complicated because von Willebrand factor levels vary with stress, inflammation, hormones and blood group, so testing may need to be repeated. Treatment depends on the type and severity and may include antifibrinolytic medication, desmopressin for suitable patients or von Willebrand factor replacement for selected procedures or significant bleeding.
Initial testing may include a full blood count, blood film, PT/INR, APTT, fibrinogen and liver function. Depending on the history, more specialised testing can include von Willebrand studies, individual clotting factor assays, platelet function tests or investigations for immune platelet conditions. Because some clotting factor levels change during pregnancy, acute illness and inflammation, the timing of testing can affect interpretation.
If a patient is being assessed before surgery, the haematologist considers both the diagnosis and the bleeding risk of the planned procedure. A written haemostatic plan can outline whether treatment is needed before or after the procedure and when medicines such as anticoagulants or antiplatelet agents should be managed differently.
Treatment varies widely. Some mild inherited disorders require treatment only for surgery or dental procedures. ITP may be monitored when platelets are at a safe level, while symptomatic or severe cases can require corticosteroids, intravenous immunoglobulin or other immune-directed therapies. Heavy menstrual bleeding may be managed in collaboration with a GP or gynaecologist, using haemostatic and hormonal approaches where appropriate.
The purpose of specialist care is to give patients a clear explanation of their bleeding risk and a plan that can be used by other clinicians. Northern Blood & Cancer Care can liaise with surgeons, dentists, obstetricians and anaesthetists when a known or suspected bleeding disorder needs procedural planning.
Referral may be appropriate when bleeding symptoms or platelet abnormalities are persistent, clinically significant or important for an upcoming procedure. Examples include:
Heavy or uncontrolled active bleeding requires urgent medical assessment rather than a routine outpatient appointment.
Northern Blood & Cancer Care brings together Melbourne specialists with complementary clinical, hospital and research appointments. The clinicians most closely associated with this service include:
Specialist assessment to understand the cause and guide the right treatment. Northern Blood & Cancer Care combines detailed clinical assessment with specialist laboratory haematology to investigate unexplained bleeding, von Willebrand disease, immune thrombocytopenia and other platelet disorders. Where surgery, dental treatment or pregnancy is involved, the team can also help develop a practical haemostatic plan with the other clinicians involved in your care.
Northern Blood & Cancer Care brings together a highly experienced team of haematologists, medical oncologists and specialist physicians, with consultations available at Northern Private Hospital in Epping.
Contact our team to arrange an appointment or discuss a referral.
