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Bleeding/bruising symptomatology in children with and without bleeding disorders
B Nosek-Cenkowska1, M S Cheang, N J Pizzi
1Department of Pediatrics, University of Manitoba, Winnipeg, Canada.
Insights
Many healthy children exhibit bleeding and bruising tendencies, with nearly 40% experiencing frequent nosebleeds. These symptoms are significantly more common in children with diagnosed bleeding disorders.
Area of Science:
- Pediatric Hematology
- Clinical Research
Background:
- Assessing bleeding and bruising tendencies in children is crucial for identifying potential hemostatic disorders.
- Tonsillectomy and adenoidectomy are common pediatric procedures where bleeding complications are a concern.
Purpose of the Study:
- To evaluate the prevalence of bleeding and bruising symptoms in otherwise healthy children undergoing tonsillectomy/adenoidectomy.
- To compare these tendencies between a cohort of non-bleeding children and a cohort with diagnosed bleeding disorders.
Main Methods:
- A questionnaire was administered to 251 children undergoing tonsillectomy/adenoidectomy to assess bleeding/bruising history.
- 228 children without excessive bleeding were classified as 'non-bleeders' for analysis.
- A comparative group of 31 patients with known bleeding disorders (von Willebrand's disease, platelet function defects) was studied.
Main Results:
- A significant proportion of 'non-bleeding' children reported easy bruising (24%), weekly bruises (36%), and nosebleeds (39%).
- Children with bleeding disorders showed substantially higher frequencies of these symptoms (67-69%).
- Severe bruising manifestations like multiple bruises or hematomas were rare in non-bleeders but common in bleeders.
Conclusions:
- Even in children without diagnosed bleeding disorders, mild bleeding and bruising symptoms are prevalent.
- The study highlights the need for careful pre-operative assessment of bleeding tendencies in pediatric patients.
- Distinguishing between mild, common bruising and significant bleeding disorders is essential for appropriate patient management.
Abstract:
A questionnaire, designed to assess bleeding/bruising tendencies, was administered to 251 otherwise healthy children undergoing a tonsillectomy and/or adenoidectomy. 23 children with excessive bleeding during or after the operation, with a long bleeding time or who reported taking aspirin recently were excluded, to give a population of 228 non-bleeders. For comparative purposes, 31 patients with bleeding disorders (von Willebrand's disease and/or platelet function defects) were studied. A considerable proportion of "non-bleeding" children reported easy bruising (24%), had bruises at least once a week (36%) and suffered from nosebleeds (39%). The respective frequencies (67%, 68% and 69%) for children with bleeding disorders were significantly higher. Occurrence of bruises usually on more than one part of the body, frequent large bruises or hematomas were rare in "non-bleeders" (4.9%, 3.5% and 2.7% respectively), but more common in "bleeders" (38.5%, 29.6% and 21.7% respectively).