ABSTRACT
Hematohidrosis is a very rare yet fascinating clinical entity in which blood is excreted in sweat under extreme physical or emotional stress. The causes can be attributed to variety of etiological factors such as systemic disorders, vicarious menstruation, excessive exertion, and psychogenic and idiopathic causes. Although the episodes are usually self-limiting and do not affect the health status of the patient, the very phenomenon can be quite scary for the patient and family members. Amongst the psychogenic causes, various mental illnesses can result in Hematohidrosis, but it is more commonly reported so far with anxiety spectrum illnesses and depression. The distinctive feature of the case presented by authors is its association with Hematohidrosis and its symptoms of Paranoid Schizophrenia. Objective of this study the association between symptomatology of Paranoid Schizophrenia and its effect on Hematohidrosis After due consent from the patient, relatives and permission from the ethics committee of the institution, clinical history was obtained from the patient interviews. The case was followed longitudinally on each follow up. Appropriate blood investigations were done. Information obtained was compiled to form a case report. The improvement in psychotic symptoms corresponded with reduced frequency of bleeding episodes. As anti-psychotic treatment was initiated, patient started showing improvement in psychotic symptoms. This co-incided with the reduced severity and frequency of Hematohidrosis. Improvement in anxiety associated with psychotic symptoms was most probably responsible for improvement in symptoms of Hematohidrosis.
ABSTRACT
Introducción: la hematohidrosis es una rara condición clínica donde el paciente exuda sangre. Presentación de caso: se presenta el caso de una joven de 13 años, sin antecedentes mórbidos conocidos, que fue referida por Departamento de Hematología a Salud Mental por presentar cuadro de 7 meses de evolución, caracterizado por sangrado de oídos, ojos, boca, ombligo, cabeza, mamas y dedos, ocurriendo con más frecuencia cuando cursa con períodos menstruales. Se le realizaron analíticas y estudios especializados que incluían hemograma, glicemia, perfil renal, hepático, virales, electrolitos, perfil tiroideo, uroanálisis, Factor viii, Factor vii, Factor de Von Willebrand, TP, TTP, INR, fibrinógeno y extendido de sangre periférica. Además, se realizó TAC de cráneo y radiografía de senos paranasales. Todas las pruebas estaban dentro de los parámetros de normalidad. Se inicia tratamiento con Hidroxicina 25 mg c/24 horas y clonazepam 2mg c/24 horas. Con el tratamiento farmacológico cedió el sangrado de la paciente. Conclusión: el paciente fue diagnosticado con hematohidrosis, clínicamente, por exclusión. Actualmente no hay tratamiento disponible para esta condición. La etiología es desconocida hasta la fecha. El estrés se vincula como un factor precipitante
Introduction: Hematohidrosis is a rare clinical condition where the patient exudes blood. Presentation: We present the case of a 13-year-old girl, with no known morbid history, who was referred by department of hematology to mental health for presenting a 7-month evolution, characterized by bleeding of ears, eyes, mouth, navel, head, breasts and fingers occurring more often when going through menstrual periods. Analyzes and specialized studies were performed that included hemogram, glycemia, renal, hepatic, viral, electrolyte, thyroid profile, uroanalysis, Factor viii, Factor vii, Von Willebrand Factor, TP, TTP, INR, fibrinogen and peripheral blood smear. In addition, a CT scan of the skull and x-ray of the paranasal sinuses was performed. All the tests were within normal parameters. Treatment was started with Hydroxyzine 25 mg every 24 hours and clonazepam 2mg every 24 hours. With the pharmacological treatment, the bleeding of the patient subsided. Conclusion: The patient was diagnosed with hematohidrosis clinically by exclusion. Currently, there is no treatment available for this condition. The etiology is unknown to date. Stress is linked as a precipitating factor