Physicians Report Rare Case of a Patient Sweating Blood

Bleeding discharge from the forehead (A) and lower face (B) of a 21-year-old woman.

A bizarre medical mystery has been making the rounds this week on news sites and social media concerning an Italian woman who literally sweats blood. The story behind the story is even more intriguing.

According to a report published this week in the Canadian Medical Association Journal, a 21-year-old woman in Florence walked into a medical ward bleeding from her face and hands. The blood appeared to be real — and appeared to be hers — but doctors could find no wounds or lesions.

The woman disclosed that she had been regularly sweating blood for years. The bleeding incidents happened spontaneously, both when awake and sleeping, and could last up to five minutes. She never reported the condition, which had taken a toll on her mental health, leading to isolation and depression.

“Our patient had become socially isolated owing to embarrassment over the bleeding and she reported symptoms consistent with major depressive disorder and panic disorder,” wrote doctors Roberto Maglie and Marzia Caproni.

After examining her skin and taking samples of the fluid, the doctors confirmed that the woman was indeed sweating blood through the pores of her skin. The medical team found no evidence of psychosis or factitious disorder — the clinical euphemism for “faking it.”

Histologic analysis from a bleeding area showed normal skin without any relevant histopathologic changes

The doctors from the University of Florence published details on the perplexing case this week, revealing more layers to the mystery.

In a commentary published with the initial case report, medical historian Jacalyn Duffin of Queen's University in Canada suggests that incidents of spontaneous blood sweat actually span the globe and go back thousands of years.

There's even a name for the condition – hematohidrosis – but it's so exceedingly rare that researchers have essentially ignored the phenomenon. No one had previously connected the dots in the medical literature.

Duffin found more than two-dozen cases of the condition from around the world in the past 15 years. In these modern cases, doctors had used modern methods of diagnosis to confirm that the blood was indeed seeping through the skin.

Duffin discovered reports of spontaneous bleeding going all the way back to the writings of Aristotle. She rooted out more than 40 references from the Middle Ages through to the 19th century. While some of these writings are simple descriptions, others are the equivalent of case reports from physicians of each era.

“When I saw the Italian case, I was really skeptical, quite honestly,” Duffin told Seeker. “There are so many similarities in the clinical presentation that I basically talked myself out of skepticism and I now believe that it's possible and plausiable that it happens.”

Duffin, initially recruited to peer-review the Italian report, said she quickly became fascinated by the topic.

“I got a double whammy on that one, because I'm both a hematologist and a medical historian,” she said.

Duffin believes incidents of hematohidrosis may be underreported. Doctors are hesitant to document or publish when they comes across a condition that isn't in the medical literature. The assumption is often that the patient is faking it, or is somehow deluded.

“That raises the question, are doctors ignoring it?” Duffin said.

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