Hematohidrosis: An Unusual Case of a Woman Sweating Blood

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Canadian Medical Association Journal

Sweating Blood: Could it be a sign of danger?

A 21-year-old woman from Italy reported to the hospital with the complaint of sweating blood for the past three years. She experienced it during her sleep and during increased physical activity. Furthermore, she observed that the blood in her sweat increases when she is under stress. These episodes lasted for 1 to 5 minutes, occurring on her palms and face.

On examination, the doctors found no visible skin lesions or any other anomaly that could explain the unusual blood-stained sweat.

Investigations

The patient had developed social anxiety due to the embarrassment caused by these episodes. Therefore, the doctors performed a psychiatric evaluation, which was positive for major depressive disorder and anxiety disorder.

The doctors sent her blood samples for baseline investigations including Full Blood Count (FBC), and coagulation profile to rule out any underlying bleeding disorders.

Is treatment possible?

The doctors began treating her depression and anxiety with paroxetine and clonazepam. However, they were unable to start treatment for the blood in the sweat. Therefore, she was admitted to the hospital for observation.

During her stay in the hospital, she experienced another episode of “bloody sweat”. The doctors examined this sweat and found red blood cells in it, which confirmed the diagnosis of “hematohidrosis”.

Hematohidrosis: sweating blood without any underlying cause

This is a rare medical condition in which bleeding occurs from intact and mucous membranes. This bleeding can occur in the form of sweat or tears.

There are few studies in the medical literature that report such cases. Moreover, despite the rise in the prevalence of such cases, there is still speculation about the underlying pathology of this condition. Some theories suggest that an increase in blood pressure could be responsible for leading to the passage of blood into the sweat gland ducts. Another theory suggests that rupture of small blood vessels could be the cause.

Treatment

The doctors treated the patient with Propanol which helped reduce the blood in the sweat. However, she did not recover completely.

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