Blood Disorders

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The blood disorders team at UT Southwestern Medical Center provides comprehensive care for children and adults with anemia, von Willebrand disease, hemophilia, sickle cell disease, and other blood disorders.

Our doctors offer the latest diagnostic tools and treatments and participate in clinical research to advance care for blood disorders.

World-Class Care for Children and Adults with Blood Disorders

Blood disorders occur when one or more components of the blood are not working properly. Those components include:

Red blood cells, white blood cells, and platelets, which are found in the solid part of the blood
Proteins, which are found in the liquid part of the blood (plasma) and affect the blood clotting process

Blood disorders can be inherited or acquired, and they can be acute or chronic. Symptoms vary depending on the type of blood disorder.

UT Southwestern’s multidisciplinary blood disorder team brings together a group of specialists who can diagnose and treat the full spectrum of blood disorders. We are also leaders in researching and improving the understanding of blood disorders.

Types of Blood Disorders

Red Blood Cell Disorders

Conditions affecting the red blood cells, which are tasked with moving oxygen throughout the body, include:

Anemia, the most common blood disorder, which is characterized by low levels of red blood cells. Iron-deficiency anemia is the most common type.
- Other types include anemia caused by:
  - Chronic disease
  - Pernicious anemia
  - Aplastic anemia
  - Autoimmune hemolytic anemia (AIHA). AIHA includes cold agglutinin disease, a rare form in which a person’s body attacks red blood cells when the temperature gets cold.
Sickle cell disease, an inherited disorder that affects the ability of red blood cells, or hemoglobin, to carry oxygen to the cells throughout the body.
Thalassemia, which affects production of red blood cells and hemoglobin.
Polycythemia vera, which is characterized by high levels of red blood cells.
Paroxysmal nocturnal hemoglobinuria (PNH), a rare, acquired disorder that affects the bone marrow and causes red blood cells to break apart early. Some people with PNH develop aplastic anemia or vice versa.
Pure red cell aplasia (PRCA), a rare bone marrow disorder that affects red blood cell production and causes anemia. It can be acquired or inherited.

White Blood Cell Disorders

Conditions affecting the white blood cells, which are found in the bone marrow and have a variety of functions, include:

Leukopenia, which is characterized by low levels of white blood cells
Leukocytosis, which is characterized by high levels of white blood cells

Bleeding (Platelet) Disorders

Bleeding disorders, which affect the blood clotting process, include:

Von Willebrand disease, which is the most common inherited bleeding disorder and is caused by a clotting factor deficiency. Inherited forms of the disorder include Type 1 (the most common type), Type 2, and Type 3. Von Willebrand disease can also be acquired.
Hemophilia, a rare bleeding disorder caused by a clotting factor deficiency. Hemophilia A, also known as classic hemophilia, is the most common type. Other types include Hemophilia B, also known as Christmas disease, and acquired hemophilia, also known as autoimmune hemophilia.
Other rare clotting factor deficiencies, such as I, II, V, VII, X, XI, XII, and XIII
Congenital (inherited) platelet disorders
Thrombocytopenia, which is characterized by a drop in platelets. It can be a side effect of cancer treatment, and it can also affect people who don’t have cancer.
Thrombocytosis, which is characterized by increased production of platelets
Blood clots, including thrombosis
Atypical hemolyticuremic syndrome (aHUS), which causes potentially harmful blood clots to form in blood vessels in the kidneys

Blood Cancers

Large granular lymphocytic (LGL) leukemia, a rare form of white blood cell cancer that affects the lymphocytes

Genetic Blood Disorders

Porphyria, a group of rare genetic blood disorders that affect the skin and nervous system, mainly causing blistering of the skin and/or abdominal pain attacks.

Causes of Blood Disorders

Some blood disorders are inherited, meaning they are caused by a gene mutation and present at birth. Some people acquire, or develop, blood disorders due to infections, other medical conditions, medication side effects, or nutrition deficiency. In some cases, the cause is unknown.

For example, the most common type of anemia is caused by low iron levels. Some types of anemia are inherited while others are caused by chronic disease, such as kidney disease. Most of the time, hemophilia is inherited, but some people acquire it. Acquired hemophilia is associated with pregnancy, autoimmune conditions, cancer, multiple sclerosis, and reactions to drugs. Occasionally, the cause is unknown.

Paroxysmal nocturnal hemoglobinuria (PNH) is an example of an acquired blood disorder. It’s caused by an acquired mutation of the PIGA gene, which affects bone marrow stem cells involved in blood cell production. The disorder might occur due to weakness or failure of the bone marrow.

Acquired pure red cell aplasia (PRCA) is also connected to bone marrow failure. PRCA may occur due to an autoimmune disorder, a thymus gland tumor, a viral infection, certain blood cancers, or use of certain medications. In some cases, the cause is unknown.

Symptoms of Blood Disorders

Symptoms vary depending on the type of blood disorder and what part of the blood is affected.

Symptoms of blood disorders affecting the red blood cells include:

Feeling fatigued, weak, or cold
Shortness of breath
Headache

Symptoms of blood disorders affecting the white blood cells include:

Fever
Frequently developing infections

Symptoms of bleeding (platelet) disorders include:

Continuous bleeding or bruising after an injury, surgery, dental care, or a shot, such as a vaccination
Easy bruising
Blood clots
Frequent nose bleeds
Heavy menstrual bleeding
Skin rash

Diagnosing Blood Disorders

At UT Southwestern, our doctors check for blood disorders by examining the patient, reviewing the patient’s medical history, and ordering blood tests, such as a complete blood count (CBC), to check for blood disorders. A CBC measures blood components, including red blood cells, white blood cells, hemoglobin, and platelets.

Tests are available to check for specific conditions, including hemophilia, von Willebrand disease, polycythemia vera, and paroxysmal nocturnal hemoglobinuria (PNH).

If hemophilia is suspected, our providers might recommend a blood test to measure how much clotting factor is in the blood and how long it takes the blood to clot. We use this information to diagnose the type of hemophilia and to classify the disorder as mild, moderate, or severe.

If PNH is suspected, our providers might recommend a blood test called flow cytometry. This test looks for PNH cells, which are blood cells lacking a crucial protein.

In certain cases, we might recommend a bone marrow biopsy to assist with diagnosis.

For some blood disorders, such as sickle cell disease and severe hemophilia, early diagnosis is essential in providing proper preventive treatment for complications.

Our pediatric hematologists perform a careful evaluation of each child – including providing biopsies in collaboration with our UT Southwestern partners in Dallas when necessary and when there is a concern for cancer. Once we have a diagnosis, we use the latest therapies to provide specialized, compassionate care.

Blood Disorders Treatment

With treatment, some blood disorders resolve. Chronic blood disorders may be managed but persist throughout the patient’s life.

The range of treatments for blood disorders includes:

Medications
Oral iron tablets
Vitamin B12 injections
Steroids
Clotting factor replacement therapy

Anticoagulant therapy
Transfusions
Immunosuppressive therapy
Bone marrow transplantation

Our multidisciplinary team will determine the appropriate course of treatment, which depends on the type and severity of the blood disorder, and provide education on how to prevent complications and stay healthy.

In addition to treatment, people with blood disorders can help prevent complications by maintaining healthy habits, including:

Choosing a nutritious diet with plenty of vitamins and minerals. For example, iron-rich foods include leafy green vegetables, black beans, brown rice, eggs, turkey, lean beef, and kidney and liver meat.
Staying hydrated
Exercising regularly, while taking precautions to prevent injury. For example, people with hemophilia should avoid contact sports.
Avoiding sitting for long stretches of time
Keeping up with doctor appointments and blood tests
Being proactive about preventing infections – for example, by practicing good hand hygiene and keeping up with immunizations such as flu shots

Support Services for Blood Disorders

At UT Southwestern, we deliver comprehensive care that extends outside our clinic. We can help you coordinate with social workers and financial counselors. When needed, we can refer you to experts in physical therapy, oral surgery, orthopaedic surgery, infectious diseases, and hepatology.