title: Diagnosis and management of bleeding disorder in a child.
abstract: Children with symptoms of bleeding and bruising are commonly seen in clinical practice. Primary care providers should be able to decide when and whether evaluation for bleeding disorder is warranted. This decision depends on one's index of suspicion for bleeding disorder based on history, physical examination, and screening laboratory investigations. Knowledge of the hemostatic physiology is essential to be able to order appropriate laboratory investigations and their accurate interpretation. Prothrombin time (PT), activated partial thromboplastin time (aPTT), and blood platelet concentration constitute the initial diagnostic work up of any bleeding disorder. Abnormality in any of these parameters in a child with excessive bleeding should lead to presumptive diagnosis of bleeding disorder and trigger referral to a hematologist for confirmation and definitive treatment. Awareness of basic treatment principles for management of bleeding/clotting disorders may prepare the provider to develop appropriate management plans, especially in a life threatening situation.
authors.affiliation: Children's Hospital of Michigan, Detroit, MI 48201, USA. asarnaik@dmc.org
authors.forename: Amit
authors.initials: A
authors.lastname: Sarnaik
authors.forename: Deepak
authors.initials: D
authors.lastname: Kamat
authors.forename: Nirupama
authors.initials: N
authors.lastname: Kannikeswaran
mesh_terms: D000293:Adolescent; D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D001779:Blood Coagulation Factors / Q000032:analysis; D001780:Blood Coagulation Tests; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010314:Partial Thromboplastin Time / Q000379:methods; D010808:Physical Examination; D010976:Platelet Count / Q000379:methods; D011320:Primary Health Care / Q000379:methods; D011379:Prognosis; D011517:Prothrombin Time / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D013918:Thrombin Time
chemical_list: D001779:Blood Coagulation Factors