[Haemolacria: etiopathogenesis, diagnosis, treatment]. / Gemolakriya: etiopatogenez, diagnostika, lechenie.

This article is devoted to the problem of haemolacria, which is a condition that causes a person to produce tears containing blood. The article generalizes and analyzes the data on this rare pathology from scientific literature, systematizes the information about etiopathogenesis of haemolacria and its clinical manifestations, describes possible diagnostic and treatment options, and presents the points of view of authors on this disease. The main purpose of this review is to inform about this rare pathology, which a doctor of any specialty has a chance to encounter.

A rare complication of hemolacria after Le fort I osteotomy: a case presentation.

BACKGROUND: Nasolacrimal duct obstruction (NDO) is a common pathology preventing the proper drainage of the tears, and its main symptom is epiphora. Secondary acquired nasolacrimal duct obstruction (SANDO) can be due to a variety of causes including infection, trauma, or neoplasms. It has been reported to occur with different forms of maxillofacial trauma, especially Le Fort II, Le Fort III, naso-orbital-ethmoidal, and orbital floor fractures. CASE PRESENTATION: A 20-year-old Egyptian female presented to correct a facial disharmony due to a cleft lip and palate defect. The patient reported a history of congenital NDO and had deficient lateral nasal walls. Bimaxillary surgery was planned, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split osteotomy for the mandible. The surgery was uneventful, but the patient complained from bloody tears or hemolacria few days postoperatively. This complication began to cease spontaneously after 2 days and completely recovered after 4 days. CONCLUSION: Hemolacria is an infrequent finding after maxillofacial surgeries and may be associated with CLP surgeries more than other surgeries. In this case, it was easily managed, and surgeons should be more aware of it to try to prevent its occurrence.

Haemlacria: A mini case series of a rare condition.

Haemlacria is a rare condition which is not widely mentioned in literature. In this mini case series, we describe two cases with this presentation. Both the patients were women with unilateral presentation of haemlacria in the right eye. Case one was diagnosed with photosensitivity, while case two was assumed to be due to an undiagnosed systemic illness which led to her mortality. Careful history, systemic examination, slit- lamp biomicroscopy, fundus examination, relevant haematological tests like coagulation profile, liver function test along with nasolacrimal duct probing with syringing and appropriate imaging may be needed to arrive at a diagno sis. Though many cases are idiopathic yet this can be a sign of an underlying life-threatening disease.

Haematohidrosis in a 12-year-old boy: blood, sweat and tears.

A 12-year-old boy presented with a 1-year history of episodes of spontaneous bleeding from multiple sites lasting for a few minutes. His medical history was unremarkable and all the episodes of bleeding began after he was separated from his aunt to whom he was very much attached. She had moved out of their home following her marriage. All haematological investigations were normal. He was diagnosed with haematohidrosis secondary to adjustment disorder, and behavioural therapy was advised and propranolol prescribed. At present he is asymptomatic and on regular follow-up.Explanations of terms used in the text: Adjustment disorder: maladaptive response to a psychosocial stressor in an individual with significant difficulty coping with a stressful psychosocial event; anxiolytics: medication that reduces anxiety; chromohydrosis: secretion of coloured sweat; haematochezia: passage of fresh blood through the anus, usually in or with stools; haematohidrosis: sweating blood; oto-erythrosis: spontaneous bleeding from the ear; otorrhagia: haemorrhage from the ear; vicarious menstruation: cyclical bleeding outside the uterine cavity during the menstrual cycle.

Sudden-onset haemolacria in an adolescent girl.

Haemolacria, also known as bloody tears, is a physical condition in which a person produces tears partially composed of blood. Multiple disorders can cause haemolacria, including trauma, inflammation, vascular lesions, vicarious menstruation, blood disorders, epistaxis, tumours and psychiatric and systemic disorders. Often, no aetiology is identified. It is usually benign, self-limiting, and the treatment depends on the cause. A 14-year-old girl presented to the paediatric emergency department with sudden onset of bloody tears from both eyes and epistaxis for the first time. A detailed history focusing on aetiological factors was unremarkable. Systemic, ocular, nasal and paranasal examination was also unremarkable. Radiological and laboratory investigations were normal, and the patient was diagnosed with idiopathic haemolacria. High-dose oral vitamin C, prophylactic iron therapy and psychological support were provided as conservative treatment. During regular follow-up, there was a spontaneous reduction in the frequency of symptoms.

[Bloody tears: About a case and a review of the literature]. / Quel bilan devant une haemolacria ? À propos d'un cas et revue de la littérature.

INTRODUCTION: Hemolacria is a rare hemorrhagic syndrome characterized by bloody tears. The most common etiologies are inflammation, infection or laceration. However, other rarer diseases may also cause this clinical manifestation. CASE REPORT: We describe the case of a 14-year-old male patient hospitalized for hemolacria. A history of von Willebrand disease was present in his family, diagnosed in his mother and sister, but absent in our patient. A vitamin C dosage was obtained in our patient and revealed scurvy consecutive to malnutrition. After having excluded other bleeding symptoms like bruises we retained vitamin C deficiency as the etiology of the hemorrhagic syndrome. CONCLUSION: Bloody tears are a rare clinical manifestation and the etiology may be difficult to determine. Bloody tears are a rare clinical manifestation of hemorrhagic syndrome. To determine the underlying etiology, screening should consider all possible causes including the rarest.

A healthy infant with bloody tears: Case report and mini-review of the literature.

A 4-month old healthy infant was brought by her parents to the emergency department with bloody tears of three days duration. There was also intermittent yellowish discharge since birth and a history of flu-like symptoms a week prior to presentation. Extensive investigations revealed no infection or other possible etiologies. The patient was treated with antibiotic eye drops and her condition resolved within a three-four days. In the literature, 15 cases with haemolacria of undermined source were reviewed; the median age of onset (12 years), bilateral involvement and female gender were more commonly encountered, and the most common associated illnesses were headache and epistaxis. The condition is self-limiting and spontaneous resolution is seen in majority of cases. Idiopathic haemolacria is a rare condition that can be presumed in patients presenting with bloody tears when all work-up turns to be negative. The condition is self-limiting with spontaneous resolution.

An unusual case of bloody tears.

Conjunctival bleeding although occurs in many pathological conditions enlisting diseases like purulent conjunctivitis, infection with epstian bar virus, and accidental damage to conjunctiva. We report here a rare case of bloody tears which was accompanied with severe headache in a12-years school-going girl.

Bloody tears: a rare presentation of munchausen syndrome case report and review.

We report a 16-year-old Jordanian female who presented with bleeding from both eyes of sudden onset. Her physical examination was remarkable for blood pouring from both eyes, and normal otherwise examination including eye and nose examination. During hospital stay, it was noted that "bleeding" occurred only when alone in the room. She later was seen to prick her finger tips of the left hand with her right hand using a hair clip. She denied any psychological problems, and later did not show for follow-up. Munchausen syndrome as a cause of bleeding is discussed.

Un caso pediátrico de hemolacria / A pediatric case of haemolacria

Introducción: la presencia de lágrimas con sangre -o hemolacria- es un hecho infrecuente en la práctica clínica, y ha sido denominada con distintas acepciones en la literatura médica. Las causas que originan este signo son múltiples, y comprenden desde trastornos locales en el globo ocular, hasta enfermedades sistémicas, además de las provocadas en forma artificial y en otras. En ocasiones su etiología no se ha podido demostrar. Presentación del caso: adolescente, mestiza, de 16 años de edad que fue remitida al Hospital Docente Pediátrico del Cerro por el policlínico de su área de salud, porque presentó lágrimas con sangre con epistaxis acompañada de cefaleas y calambres en extremidades inferiores, además de referir un síndrome de inmunodeficiencia adquirida desde los 13 años. Durante su estadía hospitalaria se constató en dos ocasiones hemolacria con epistaxis. Los exámenes complementarios realizados para diagnosticar algún trastorno de la coagulación, enfermedad local o sistémica no transmisible, resultaron normales. Se indicó tratamiento con antirretrovirales para su afección de base. Se explicó la posible fisiopatología de este fenómeno. Conclusiones: la causa de esta entidad en la presente comunicación queda por precisar, y es el primer caso pediátrico reportado en Cuba(AU)

Introduction: the presence of tears with blood -or haemolacria- is an uncommon event in clinical practice which has been defined in several different manners in medical literature. The causes giving rise to this sign are many, ranging from local disorders in the eyeball to systemic diseases, alongside those brought about by artificial agents and others. On occasion it has not been possible to determine its etiology. Case presentation: a mulatto 16-year-old female adolescent was referred by the polyclinic in her health area to the Pediatric University Hospital in the municipality of Cerro with bloody tears and epistaxis accompanied by headaches and cramp in her lower limbs. The patient stated she had suffered from an acquired immunodeficiency syndrome since the age of 13. During her stay in hospital two episodes of haemolacria with epistaxis could be observed. The complementary tests performed to diagnose some other coagulation disorder, local condition or non-communicable systemic disease were all normal. Treatment with antiretrovirals was indicated for her underlying disease. The possible physiopathology of the phenomenon was explained. Conclusions: the cause of the condition discussed in the present communication is still to be determined. This is the first pediatric case of haemolacria reported in Cuba(AU)

A case of recurrent bloody tears.

Well-known causes of blood-tinged epiphora are conjunctival lesions, tumors of the lacrimal apparatus, and systemic bleeding disorders. We describe an unusual patient who presented with recurrent episodes of bloody tearing which began following an erythema multiforme-like drug eruption. He experienced chronic conjunctivitis which resulted in a few minor symblephara. One year later, the patient developed attacks of bloody tearing. All clinical, radiologic, and laboratory investigations related to bloody epiphora were within normal limits except for a mild, nonspecific chronic inflammatory reaction in the perivascular tissues of the lacrimal gland and orbital soft tissues. Also, an increase in vascular permeability and contrast extravasation on carotid angiography was detected. High-dose vitamin C was administered. The patient continued to have unilateral bloody tears intermittently for two years, but the episodes became much less frequent and had resolved by three years. It is conceivable that increased vascular permeability following the systemic inflammatory process could have played a role in the etiology of recurrent bloody tears in this atypical patient.