Book chapter
Chapter 103 - Approach to the Bleeding Child
Transfusion Medicine and Hemostasis, pp.475-480
Elsevier Inc, Fourth Edition
2024
DOI: 10.1016/B978-0-323-96014-4.00092-6
Abstract
Evaluating a child with suspected bleeding disorder is a common yet challenging clinical scenario in pediatric practice. The spectrum of clinical symptoms at presentation could vary from acute bleeding diathesis presenting as hematological emergency to mild bleeding symptoms such as bruising suspicious for child abuse. Therefore, a systematic approach to evaluation of the underlying cause is important. The bleeding disorder could be inherited or acquired and requires careful assessment of primary and secondary hemostasis. Objective quantification of patient's personal history of bleeding along with family history of bleeding provides the basic foundation for subsequent evaluation. The physical exam can provide important clues. Simple bruises over the unexposed parts of the body point toward disorders of primary hemostasis while subcutaneous hematomas, deep tissue and joint bleeds suggest disorders of secondary hemostasis. Similarly, vascular bleeding in the setting of joint hypermobility syndrome is seen in Ehlers Danlos syndrome, and bruising in the setting of retinal hemorrhages or old healing fractures result from child abuse. Clinical suspicion needs to be confirmed by laboratory evaluation to reach a diagnosis and initiate appropriate treatment. This chapter outlines the approach to a child with a suspected bleeding disorder. Key points in history, examination, and investigations are reviewed.
Details
- Title: Subtitle
- Chapter 103 - Approach to the Bleeding Child
- Creators
- Ahmad Al-HunitiAnjali Sharathkumar
- Resource Type
- Book chapter
- Publication Details
- Transfusion Medicine and Hemostasis, pp.475-480
- Edition
- Fourth Edition
- Publisher
- Elsevier Inc
- DOI
- 10.1016/B978-0-323-96014-4.00092-6
- Language
- English
- Date published
- 2024
- Academic Unit
- Stead Family Department of Pediatrics; Hematology/Oncology
- Record Identifier
- 9984749734002771
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