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The rare case of a woman who stunned doctors in Italy by sweating blood from her face

By: Marwa Eltagouri, The Washington Post
October 24, 2017 Updated: October 24, 2017 at 6:24 pm
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Bleeding discharge from the forehead (A) and lower face (B) of a 21-year-old woman. (C) Histologic analysis from a bleeding area showed normal skin without any relevant histopathologic changes (hematoxylin-eosin stain, magnification × 20). (Courtesy of Canadian Medical Association Journal)

Doctors were baffled when a 21-year-old woman was admitted into an Italian hospital for “sweating blood” from her face and her hands, a condition she's had for three years, according to two physicians from the University of Florence.

It's a condition few doctors have seen, and some have questioned whether sweating blood is even possible. But it turns out dozens of similar cases have come to light since about 2000.

With the case in Italy, the bleeding has no clear apparent trigger and can happen while the woman is asleep or during physical activity, wrote doctors Roberto Maglie and Marzia Caproni in a case report published Monday in the Canadian Medical Association Journal. The bleeding becomes more intense, she told doctors, during times of stress, and the episodes can last from one to five minutes. The woman has isolated herself out of embarrassment, and reported symptoms associated with major depressive and panic disorders, doctors said.

After a round of tests and observations, and after ruling out the likelihood that she was faking her condition, doctors diagnosed the woman with a rare condition called hematohidrosis, in which patients spontaneously sweat blood through unbroken skin. But what causes the woman to “sweat” blood remains unclear: Despite the blood's sweat-like appearance, doctors aren't certain whether blood is passing through sweat glands. The bleeding reportedly has occurred through areas without sweat glands or through follicles, the doctors said.

Jacalyn Duffin, a hematologist and medical historian at Queen's University in Kingston, Ontario, said she had never come across a case of patient sweating blood herself, and that few doctors have. In a commentary that accompanied the case report, she wrote that she was initially skeptical about the condition of the woman in Italy until she dove into medical literature and found that at least two dozen similar cases had surfaced around the world since about 2000.

Of the 42 reports Duffin came across dating back to 1880, almost half had appeared in the last five years, making her wonder whether there has been an increase in cases or if it's becoming more recognized by doctors. Medical writers have previously traced the condition of sweating blood to the story of Christ's suffering and the crucifixion, but hematohidrosis has appeared in scientific literature, too. Two treatises by Aristotle from the third century B.C. reference sweat that either looked like, or actually was, blood.

Still, Duffin believes the condition's association with Christianity and religion may make it more difficult for doctors to accept. Since publication of the Italian case Monday, three people have contacted Duffin to tell her they believe they have the condition.

“That suggests to me that there may be more people who get it,” she said. “They either aren't taken seriously by their doctors, or they hide it because it's stigmatized.”

Recently reported cases make Duffin believe the condition is both “possible and plausible,” as the reports are credible, she said. Patients with hematohidrosis have their blood tested and are monitored by doctors, who look to see whether patients are scratching themselves. The majority of cases involve young women or children from around the world, making it difficult for Duffin to believe that the cases are a result of copycat behavior.

Many of the reports Duffin analyzed documented that the bleeding was preceded by emotional trauma, such as witnessing violence at home or at school. In all cases, the condition was transient, lasting anywhere from a month to four years. But little else about the bleeding, such as its causes or how to stop it, is known, she said.

The woman in Italy so far has been treated with propranolol, a heart and blood pressure medication, which has reduced but not completely stopped her bleeding.

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Read this story at The Washington Post.

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