A woman in Italy has the medical community talking after it was reported she sweats blood from her palms and face.
According to the report, which is featured the recent issue of the Canadian Medical Association Journal (CMAJ), the 21-year-old woman was admitted to the hospital after experiencing this condition for three years.
The woman, physicians from the University of Florence say, only seems to sweat blood when she engages in physical activity or while sleeping.
While the trigger for her symptoms is unknown, the woman told physicians that the sweat would intensify during times of emotional stress.
Doctors even said they witnessed the patient sweating blood themselves and there didn’t appear to be any lesions present that would cause such bleeding.
“Our patient had become socially isolated owing to embarrassment over the bleeding and she reported symptoms consistent with major depressive disorder and panic disorder,” the report reads. “There was no history of psychosis.”
In the meantime, doctors say they treated her depression and anxiety disorder, but the bleeding continued.
After conducting several tests, doctors were able to confirm that the woman’s blood count and blood-clotting abilities were normal.
Doctors then narrowed it down to two possibilities: a factitious disorder and a rare condition known as hematohidrosis. They concluded the latter based on the presence of erythrocytes which appeared during microscopic examination.
Hematohidrosis is an uncommon disease where blood sweats through intact skin, the paper explains. While a definitive cause is still a mystery, causes that have been proposed include systemic diseases like vicarious menses and coagulopathies (often historically reported in malaria, scurvy and epilepsy). Other possibilities have included exertion and psychogenetic disorders.
The patient is being treated with propranolol (20mg/day), a treatment which has been used according to historic literature. The woman’s symptoms have become better, though they haven’t completely disappeared.
When Dr. Michelle Sholzberg, a clinical hematologist at St. Michael’s Hospital in Toronto, read about the case, she was intrigued.
“I’ve never seen a case like this before,” she says. “But I did not think that the symptom of hematohidrosis was indicative of an underlying bleeding disorder. Instead, my first thought was that this was likely indicative of an abnormal communication between the sweat glands and the blood vessels.”
However, Sholzberg does admit there was a bit of skepticism.
Hematohidrosis has rarely been reported in literature and only a few reports exist, according to a 2013 study by the Institute of Post Graduate Medical Education an Research — one of them involving a 12-year-old girl.
According to this report, the girl had no bleeding disorder or other underlying cause. In this case, the patient was given the atropine sulphate transdermal patch, which was found to help (but not eradicate) her symptoms.