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Bruising and bleeding in infants and children--a practical approach
1Haemophilia Comprehensive Care Centre, Great Ormond St NHS Trust, London, UK. khairk@gosh.nhs.uk
British Journal of Haematology
|April 29, 2006
Summary
Investigating unexplained bruising in children requires careful consideration of both inherited bleeding disorders and non-accidental injury (NAI). Early diagnosis of hemostatic abnormalities is crucial for appropriate management.
Area of Science:
- Pediatric Hematology
- Child Abuse Pediatrics
Background:
- Bruising and bleeding in children often result from minor trauma.
- Significant bruising may indicate underlying hemostatic abnormalities or non-accidental injury (NAI).
Purpose of the Study:
- To outline the investigation of the hemostatic system in children presenting with bruising or bleeding.
- To emphasize the importance of excluding key hemostatic disorders.
Main Methods:
- Review of diagnostic challenges in pediatric hemostasis.
- Emphasis on differential diagnosis between bleeding disorders and NAI.
- Description of key hemostatic tests for pediatric evaluation.
Main Results:
- Diagnosing hemostatic disorders in children presents unique difficulties.
- The possibility of NAI must be considered, even in children with known bleeding disorders, if injury severity and history are incongruent.
Conclusions:
- A thorough investigation of the hemostatic system is essential for children with unexplained bruising or bleeding.
- Distinguishing between inherited bleeding disorders and NAI requires careful clinical and laboratory assessment.
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