A Rare Case of Blood & Sweat: Hematohidrosis

Hematohidrosis is a rare pathophysiological condition of sweating blood. History also has quoted this rare disease were it is said Jesus sweated blood before his crucification and the great artist Leonardo da Vinci wrote about a soldier who had bloody sweat after battle, however with rare pathophysiology this disease has been recorded rarely.

So a case study of a young lady who presented with abrupt bleeding from the skin. The bleeding was vanished after wiping with no site of injury, but it reappeared soon enough confirming its nature. Bleeding time (BT), clotting time (CT), and the prothrombin time (PT) was within normal limit.

This 19-year-old female presented envy with complaints of occasional loss of consciousness at home with violent random movements of limbs and bending of the spine followed by spontaneous recovery along with bleeding from the nose and eyes.

She was hospitalized 4 years back as she was found unconscious at her home-stairway with bleeding from her nose and ears. Complete Blood Count, coagulation profile, and CT brain was normal as she was discharged after observation. A similar episode of bleeding from the nose and mouth occurred after a month and again she was hospitalized but once again blood profile parameters were normal.

ENT consultation revealed no source of bleeding even after fibreoptic laryngoscopy (FOL) and she was advised to take oral tranexamic acid at home in case of emergency (SOS). A couple of similar episodes happened as she was taking psychiatric therapy for anxiety disorder as loss of consciousness (LOCs) were considered anxiety sequelae. In 2018 she developed new symptoms, that is, shedding of bloody tears associated with bloody salivation. Benzidine test was found positive for tear and saliva samples proving the theory of the presence of blood mixed with saliva and tear.

As of now researchers highlighted that psychological anxiety is a predisposing cause for hematohidrosis.

In conclusion though it is a very rarely reported case in medical literature, doctors should keep a close watch on their daily patient interactions to register more cases of hematohidrosis to know further about it.

Reference: Chatterjee A, Chowdhury DK, Kundu A, et al. A Rare Case of Blood & Sweat: Hematohidrosis. J Assoc Physicians India 2022;70(10):81–82.