Patterns of bruising in preschool children with inherited bleeding disorders: a longitudinal study

  title={Patterns of bruising in preschool children with inherited bleeding disorders: a longitudinal study},
  author={Peter W. Collins and Melinda Hamilton and Frank Dunstan and Sabine Ann Maguire and Diane Nuttall and Ri Liesner and Angela E. Thomas and John P. Hanley and Elizabeth A Chalmers and Victor S. Blanchette and Alison Mary Kemp},
  journal={Archives of Disease in Childhood},
  pages={1110 - 1117}
Objective The extent that inherited bleeding disorders affect; number, size and location of bruises in young children <6 years. Design Prospective, longitudinal, observational study. Setting Community. Patients 105 children with bleeding disorders, were compared with 328 without a bleeding disorder and classified by mobility: premobile (non-rolling/rolling over/sitting), early mobile (crawling/cruising) and walking and by disease severity: severe bleeding disorder factor VIII/IX/XI <1 IU/dL or… 
Can TEN4 distinguish bruises from abuse, inherited bleeding disorders or accidents?
Data support further child protection investigations of a positive TEN4 screen in any pre-mobile children with a bruise and in mobile children with more than one bruise, and IBD needs to be excluded in these children.
Characteristics, complications, and sites of bleeding among infants and toddlers less than 2 years of age with VWD.
It is indicated that a high percentage of ITs diagnosed with VWD and receiving care within the multidisciplinary structure of the USHTCN have a family history of VWD, and bleeding events such as circumcision-related, oropharyngeal, and intracranial or extracranial episodes are common and are leading indicators for treatment.
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Due to prophylaxis therapy, the quality of life of children with hemophilia is similar to their peers, and this has allowed an improvement in sports participation, including team sports.
Evaluation of an Emergency Department High-risk Bruising Screening Protocol
The screening pathway could help other institutions identify occult injuries in pediatric ED patients and high-risk bruising was rarely present when infants aged <6 months were evaluated per recommendations.
Skin lesions simulating child abuse
It is essential that dermatologists support pediatricians in managing conditions that appear unusual and possibly artifactual, and knowledge of the morphology and presentation of various skin disorders is crucial to avoid incorrect diagnosis of child abuse.
Nonaccidental Injury in Pediatric Patients: Detection, Evaluation, and Treatment
Advice is provided regarding factors that contribute to abuse in children, key findings on history and physical examination that should trigger an evaluation for physical abuse, and laboratory and radiologic tests to perform when child abuse is suspected.
Making the case for greater certainty in child protection
This commentary and the related article by Arthurs et al discuss ‘diagnostic uncertainty’, a term often used in relation to cases of suspected child maltreatment, which is driven by the emergence of a strong evidence base and the development of analytical tools, such as applications of Bayes’ theorem.
Fifteen-minute consultation: Bruising in the premobile child
A case vignette is used to discuss how one would approach a bruise in the premobile infant including the evidence base.
Multiple Abusive Fractures in an Infant With a Concurrent Parathyroid Hormone-Related Peptide-Secreting Renal Tumor: Abusive Fractures Accompanying a Parathyroid Hormone-Related Peptide-Secreting Tumor.
The findings of this child's abuse findings are highly indicative of abuse in addition to his hormone-secreting tumor, and endogenous or tumor-related hyper PTH should be in the differential of underlying bone fragility.


Patterns of bruising in preschool children—a longitudinal study
There was considerable variation in the number of bruises recorded between different children which increased with developmental stage and was greater than the variation between numbers of bruises in collections from the same child over time.
Quantitation of bleeding symptoms in children with von Willebrand disease: use of a standardized pediatric bleeding questionnaire
The PBQ provides a standardized quantitation of bleeding severity in children with von Willebrand disease, and the most frequent clinically significant bleeding symptoms were surgical bleeding, bleeding after tooth extraction and menorrhagia.
Bruising and bleeding in infants and children – a practical approach
The investigation of the haemostatic system in children with bruising and/or bleeding is described with emphasis on the key haemOSTatic disorders that need to be excluded.
Bruises in infants and toddlers: those who don't cruise rarely bruise. Puget Sound Pediatric Research Network.
Bruises are rare in normal infants and precruisers and become common among cruisers and walkers and should lead to consideration of abuse or illness as causative in infants younger than 9 months.
Bleeding disorders and non-accidental injury.
Fifty children with suspected non-accidental injury, most of whom had bruising, were investigated to exclude a bleeding disorder, and four children initially had an abnormal laboratory finding--a prolonged partial thromboplastin time--which resulted in lengthy discussions during subsequent legal proceedings.
The prevalence and distribution of bruising in babies
A prevalence rate and distribution of bruising in babies is produced and sets a baseline from which to work when assessing bruises and Clinicians need to assess a baby’s level of development when considering whether a bruise is accidental.
Bruising in children who are assessed for suspected physical abuse
Feature in the presenting history, the extent and pattern of bruising differed between children with confirmed PA and those where abuse was excluded, and these findings can provide a deeper understanding of bruising sustained from PA.
Are there patterns of bruising in childhood which are diagnostic or suggestive of abuse? A systematic review
Investigating what patterns of bruising are diagnostic or suggestive of child abuse by means of a systematic review found bruises in non-mobile infants, over soft tissue areas, that carry the imprint of an implement and multiple bruises of uniform shape are suggestive of abuse.
The bleeding child; is it NAI?
  • A. Thomas
  • Medicine
    Archives of Disease in Childhood
  • 2004
By highlighting important questions in history taking, having a specific haematological screen for children being investigated for bleeding in the context of non-accidental injury, and encouraging discussion of abnormal results with a ha Hematologist, difficulties can, for the most part, be avoided.
Bruising Characteristics Discriminating Physical Child Abuse From Accidental Trauma
The body region- and age-based bruising clinical decision rule model functions as a clinically sensible screening tool to identify young children who require further evaluation for abuse.