Thromb Haemost 1991; 65(03): 237-241
DOI: 10.1055/s-0038-1647491
Original Article
Schattauer GmbH Stuttgart

Bleeding/Bruising Symptomatology in Children with and without Bleeding Disorders

B Nosek-Cenkowska
1   The Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
,
M S Cheang
2   The Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
,
N J Pizzi
3   The National Research Council of Canada, Winnipeg, Manitoba, Canada
,
E D Israels
1   The Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
,
J M Gerrard
1   The Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
› Author Affiliations
Further Information

Publication History

Received: 06 April 1990

Accepted after revision 01 June 1990

Publication Date:
02 July 2018 (online)

Summary

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 Wille-brand’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).

 
  • REFERENCES

  • 1 Stuart MJ, Miller ML, Davy FR, Solk JA. The post-aspirin bleeding time: a screening test for evaluating haemostatic disorders. Br J Haematol 1979; 43: 649-659
  • 2 Esmon CT, Owen WG. Identification of an endothelial cell cofactor for thrombin-catalyzed activation of protein C. Proc Natl Acad Sci USA 1981; 78: 2249-2252
  • 3 Ignarro LJ. Endothelium-derived nitric oxide: actions and properties. FASEB J 1989; 3: 31-36
  • 4 Buchanan MR, Haas TA, Lagarde M, Guichardant M. 13-Hydroxy-octadecadienoic acid is the vessel wall chemorepellant factor. LOX J Biol Chem 1985; 260: 16056-16059
  • 5 Wahlberg TB, Blomback M, Ruggeri ZM. Differences between heterozygous dominant and recessive von Willebrand’s disease type I expressed by bleeding symptoms and combinations of factor VIII variables. Thromb Haemostas 1983; 50: 654-658
  • 6 Gerrard JM, Docherty JC, Israels SJ, Cheang MS, Bishop AJ, Kobrinsky NL, Schroeder ML, Israels ED. A reassessment of the bleeding time: association of age, hematocrit, platelet function, von Willebrand factor, and bleeding time thromboxane B2 with the length of the bleeding time. Clin Invest Med 1989; 12: 165-171
  • 7 Mielke Jr Ch, Kaneshiro MM, Maher IA, Weiner JM, Rapaport SJ. The standardized normal Ivy bleeding time and its prolongation by aspirin. Blood 1969; 34: 204-215
  • 8 Bom GVR. Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature 1962; 194: 927-929
  • 9 Ramsey R, Evatt BL. Rapid assay for von Willebrand factor activity using formalin-fixed platelets and micro-titration technique. Am J Clin Pathol 1979; 72: 996-999
  • 10 Laurell CB. Electroimmunoassay. Scand J Clin Lab Invest 1972; 29: 29-37
  • 11 Wahlberg ThB. A method for the evaluation of clinical information exemplified for bleeding symptoms in non-severe von Willebrand’s disease type I. Meth Inform Med 1984; 23: 143-146
  • 12 Wahlberg ThB, Blomback M, Magnusson D. Influence of sex, blood group, secretor character, smoking habits, acetylsalicylic acid, oral contraceptives, fasting and general health state on blood coagulation variables in randomly selected young adults. Haemostasis 1984; 14: 312-319
  • 13 Wahlberg ThB, Blomback M, Hall P, Axelssone G. Application of indicators, predictors and diagnostic indices in coagulation disorders. I. Evaluation of a self-administered questionnaire with binary questions. Meth Inform Med 1980 19. 194-200
  • 14 Small M, Lowe GDO, Cameron E, Forbes CD. Contribution of the hematocrit to the bleeding time. Haemostasis 1983; 13: 379-384
  • 15 Livio M, Gotti C, Marchesi D, Mecca G, Remuzzi G, de Gaetano G. Uraemic bleeding: role of anaemia and beneficial effect of red blood cell transfusions. Lancet 1982; 2: 1013-1015
  • 16 Houston DS, Gerrard JM. Endothelium-derived relaxing factor inhibits intraluminal platelet aggregation, but is blocked by red blood cell hemoglobin. FASEB J 1989; 3: A1179
  • 17 Mauser Bunschoten EP, van Houvelingen JC, Sjamsoedin Visser EJM, Van Dijken PJ, Kok AJ, Sixma JJ. Bleeding symptoms in carriers of Hemophilia A and B. Thromb Haemostas 1988; 59: 349-352