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Difficult pediatric diagnoses. Bruising and bleeding
1Division of Hematology, Children's Hospital of Philadelphia, Pennsylvania.
Insights
This guide helps pediatricians evaluate children with bruising by identifying key history and physical exam clues for platelet or coagulation disorders. It outlines screening tests and therapies for childhood bleeding episodes.
Area of Science:
- Pediatrics
- Hematology
Background:
- Bruising in children can indicate underlying bleeding disorders.
- Early identification of platelet or coagulation issues is crucial.
Purpose of the Study:
- To outline an approach for evaluating pediatric bruising.
- To identify historical and physical examination findings suggestive of bleeding disorders.
- To summarize diagnostic tests and therapies for childhood bleeding.
Main Methods:
- Review of clinical presentation of bruising in children.
- Identification of key historical and physical examination findings.
- Description of screening tests for platelet function and coagulation.
- Summary of current therapeutic options for bleeding episodes.
Main Results:
- Specific historical clues and physical examination findings can suggest platelet or coagulation disorders.
- A systematic approach using screening tests aids in diagnosis.
- Effective therapies are available for managing bleeding in children.
Conclusions:
- A structured evaluation is essential for children presenting with bruising.
- Recognizing specific clinical signs guides appropriate diagnostic testing.
- Timely intervention with available therapies can effectively manage bleeding episodes.
Abstract:
An approach to the evaluation of a child who presents to the pediatrician with bruising is outlined. Important clues in the history and physical examination that suggest disorders of platelet number and function or coagulation abnormalities are presented. A scheme for using screening tests of coagulation and platelet function is followed by a brief summary of currently available therapies appropriate for bleeding episodes in children.