Sweating Blood: A Case Series of 2 Siblings With Hematohidrosis

Abstract

Hematohidrosis is a condition that presents with the excretion of blood from intact skin. Reported cases suggest emotional stress reactions as the most common inciting events. The pathogenesis of the condition is not well understood. We describe a 9-year old boy and his 6-month old half-sister with a history of bleeding episodes from the ears, eyes, and scalp, as well as other sites. Symptoms in both children have shown a positive response to propranolol, with decreased frequency and severity of bleeding. There are no prior reports of siblings with hematohidrosis, suggesting a possible genetic predisposition.

Hematidrosis: Pathophysiology and Therapeutic Strategy

“…Our series case was consistent with this depiction. The bleeding could occur on various parts of the body with occasional digestive or urinary bleeding [7,8], which was also observed in our case 2 and case 4. The episodes occur rather frequently.…”

“…We rst successfully treated a patient with b-receptor blocker propranolol, as we speculated that sympathetic nerve activation might play a role in her episodes [18]. This treatment method has been used by many other researchers, but its e ciency could be limited, and relapses occured in some cases after the drug withdrawal [1,3,8,23]. Again our seven patients did not completely response to propranolol.…”

“…Patients had no prior medical or psychological illness, and their family histories were normal, except for a boy and his half-sister who were born to a same mother, suggesting their possible genetic predisposition. However, whole genome sequencing was not performed to search its doubtful gene mutation [8].…”

“…Some extensive therapeutic intervention treatments could cause dangerous risk. A patient had been reported to be infected with human immunode ciency virus and hepatitis B virus, presumably acquired via blood transfusions [8].…”

Pediatric hematidrosis – A case report and review of the literature and pathogenesis

“…Hematidrosis is a rare condition that presents with the excretion of bloody fluid from intact skin or mucosa. 1 Cases have been reported throughout history, most notably in the Bible when Jesus was in the Garden of Gethsemane (Luke 22:44) and by Leonardo da Vinci when describing the sweating of blood by a soldier in battle. 2 The literature suggests anxiety or other emotional stress as the most common precipitating events.…”