{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T11:15:07Z","timestamp":1781954107545,"version":"3.54.5"},"reference-count":64,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A bleeding tendency is one of the most common complaints observed by hematologists. It is challenging to differentiate a clinically insignificant bleeding from a bleeding phenotype that requires hemostatic evaluation and medical intervention. A thorough review of personal and familial history, objective assessment of bleeding severity using a bleeding assessment tool, and a focused physical examination are critical to correctly identifying suspected patients with mild to moderate bleeding disorders (MBDs). A basic laboratory work\u2010up should be performed in all patients referred for a bleeding tendency. If a hemostatic abnormality is found such as evidence of von Willebrand disease, a platelet function disorder, or a coagulation factor deficiency, more extensive testing should be performed to further characterize the bleeding disorder. Conversely, if all results are normal the patient is considered to have bleeding disorder of unknown cause (BDUC). For patients with BDUC, further evaluation may include non\u2010routine testing to look for rare bleeding disorders not detected by routine hemostasis tests, such as thrombomodulin\u2010associated coagulopathy, tissue factor pathway inhibitor\u2010related bleeding disorder, hyperfibrinolytic\u2010bleeding disorders or impaired tissue factor production. In this review, we summarize the stepwise diagnostic procedure in MBDs and provide some insights into the biological features of BDUC.<\/jats:p>","DOI":"10.1111\/ijlh.14266","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T04:59:38Z","timestamp":1709873978000},"page":"27-33","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["How to investigate mild to moderate bleeding disorders and bleeding disorder of unknown cause"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7910-933X","authenticated-orcid":false,"given":"Alessandro","family":"Casini","sequence":"first","affiliation":[{"name":"Division of Angiology and Hemostasis University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Gebhart","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Division of Hematology and Hemostaseology Medical University Vienna  Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13368"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation.V2012.1.466.3798741"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000286"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13422"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13922"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13991"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14363"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12822"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2011.04265.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020010038"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14548"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2023.07.014"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2023.102242"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2019.07.004"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2022.11.009"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1758117"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021004368"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2010.03975.x"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2022.11.045"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01847.x"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15263"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-02-557264"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2020.04.023"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2020.05.025"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2019.05.012"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2023.03.006"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14454"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2020.06.008"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12792"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13584"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13702"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03273.x"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP9V3RRVNZMKDS"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15781"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15526"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14479"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12801"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2023.09.010"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003265"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14216"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14046"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13941"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2011.04315.x"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2004.00693.x"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15524"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15687"},{"key":"e_1_2_5_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14529"},{"key":"e_1_2_5_49_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.248153"},{"key":"e_1_2_5_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14160"},{"key":"e_1_2_5_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14356"},{"key":"e_1_2_5_52_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-604553"},{"key":"e_1_2_5_53_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-02-557538"},{"key":"e_1_2_5_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14990"},{"key":"e_1_2_5_55_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI69091"},{"key":"e_1_2_5_56_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-08-592733"},{"key":"e_1_2_5_57_1","first-page":"366","article-title":"Factor V Atlanta: a novel mutation in the F5 gene reveals potential new cis\u2010acting elements involved in regulating FV\u2010short and TFPI levels","volume":"130","author":"Zimowski KL","year":"2017","journal-title":"Blood"},{"key":"e_1_2_5_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14433"},{"key":"e_1_2_5_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13665"},{"key":"e_1_2_5_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12508"},{"key":"e_1_2_5_61_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003464"},{"key":"e_1_2_5_62_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI112346"},{"key":"e_1_2_5_63_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198309223091203"},{"key":"e_1_2_5_64_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI133780"},{"key":"e_1_2_5_65_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2018891192"}],"container-title":["International Journal of Laboratory Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.14266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T10:24:52Z","timestamp":1716200692000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijlh.14266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,7]]},"references-count":64,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/ijlh.14266"],"URL":"https:\/\/doi.org\/10.1111\/ijlh.14266","archive":["Portico"],"relation":{},"ISSN":["1751-5521","1751-553X"],"issn-type":[{"value":"1751-5521","type":"print"},{"value":"1751-553X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,7]]},"assertion":[{"value":"2024-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}