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First-Step Results of Children Presenting with Bleeding Symptoms or Abnormal Coagulation Tests in an Outpatient
İsmail Yıldız1, Ayşegül Ünüvar, İbrahim Kamer
1İstanbul University İstanbul Faculty of Medicine, Department of Pediatrics, Division of Ambulatory Pediatrics, İstanbul, Turkey Phone: +90 212 414 20 00
Insights
A study found that 36.4% of children with suspected bleeding disorders were diagnosed with a condition after initial outpatient screening. Key diagnoses included von Willebrand disease and hemophilia, highlighting the importance of early evaluation for pediatric bleeding symptoms.
Area of Science:
- Pediatrics
- Hematology
- Clinical Diagnostics
Background:
- Mild bleeding symptoms are prevalent in the general population, necessitating accurate diagnostic approaches.
- Early identification of bleeding disorders in children is crucial for timely management and prevention of complications.
Purpose of the Study:
- To determine the clinical and laboratory features of children referred for suspected bleeding disorders.
- To assess the diagnostic yield of initial evaluations in a pediatric outpatient setting.
Main Methods:
- Retrospective analysis of medical records for 26,737 outpatients over one year.
- Focus on 99 patients initially diagnosed with probable bleeding disorders.
- Analysis of bleeding symptoms and coagulation test results.
Main Results:
- Of 99 pediatric patients, 36.4% received a confirmed bleeding disorder diagnosis.
- Common diagnoses included von Willebrand disease (12.1%) and hemophilia A or B (9.1%).
- Epistaxis (36.4%) and easy bruising (32.3%) were the most frequent symptoms.
Conclusions:
- Initial screening tests in pediatric outpatient clinics successfully diagnosed bleeding disorders in 36.4% of referred children.
- This highlights the effectiveness of primary care in identifying significant hemostatic abnormalities.
Objective:
Mild bleeding symptoms are commonly seen in the general population. The aim of this study was to determine the final clinical and laboratory features of children referred for a first evaluation with a suspected bleeding disorder in the pediatric outpatient clinic of İstanbul University.
Materials And Methods:
The medical records of 26,737 outpatients who were admitted to the Division of Ambulatory Pediatrics between 31 October 2011 and 31 October 2012 were evaluated retrospectively. Ninety-nine patients were initially diagnosed as having probable bleeding disorders and were followed up. The symptoms of bleeding in addition to coagulation tests were analyzed.
Results:
Of the 99 patients, 52 (52.5%) were male and 47 were female, and the mean age of the entire study group was 9.1±4.1 years (minimum-maximum: 2-18 years). Major bleeding symptoms were epistaxis in 36 patients (36.4%), easy bruising in 32 (32.3%), and menorrhagia in 6 (6.1%). After initial tests ordered by the pediatrician, 36 of 99 patients (36.4%) were diagnosed as having bleeding disorders that included von Willebrand disease in 12 (12.1%), hemophilia A or B in 9 (9.1%), and other rare factor deficiencies in 9 (9.1%). Six patients (6.1%) were found to have combined deficiencies. Seven of 36 patients had a family history of bleeding.
Conclusion:
Among the patients referred for bleeding disorders, 36.4% were diagnosed with a bleeding disorder with the help of primary screening tests ordered in the outpatient clinic.
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