Dr. Roberts1

Dr. Jonathan Roberts, BCDI’s Associate Medical Director recently published an article that shed light on the challenge of diagnosing children with bleeding disorders in his article “Evaluation of Abnormal Bleeding in Children”. The article was published in Pediatric Annals and explains the challenges pediatricians and primary care providers face as they evaluate care for children with unusual bleeding symptoms. Some of those considerations are the age of the child, family history, timing and severity of the patient’s symptoms. The article provides an algorithm for providers to guide an initial evaluation before considering referral to their local coagulation hematologist.

Abnormal bleeding or bruising is a relatively common clinical concern, frequently causing parents to seek care from their children’s primary care provider. Although ecchymosis from playful trauma, occasional epistaxis, and heavy menstrual bleeding around the time of menarche and beyond are common occurrences, it can be difficult for pediatricians and other primary care providers to determine if their patient has age-appropriate symptoms versus abnormal or excessive bleeding. This review discusses considerations for abnormal bleeding in pediatrics and discusses an initial approach for evaluation of hemostasis in a child with bleed symptoms.