Review of patients studied for coagulopathy in a Hematology/Oncology unit

• Published in: Anales de pediatría (Barcelona, Spain : 2003) Spain : 2003), 2016-02, Vol.84 (2), p.85-91
• Main Authors: Romero, I, Conde, N, García Aldana, D, Ruano, A, Fernández-Teijeiro, A
• Format: Article
• Language: Spanish
• Subjects: Blood Coagulation Disorders - diagnosis; Blood Coagulation Tests; Child; Diagnosis, Differential; Factor XII Deficiency - diagnosis; Hematology; Humans; Partial Thromboplastin Time; Retrospective Studies; von Willebrand Diseases - diagnosis
• ISSN: 1695-9531
• DOI: 10.1016/j.anpedi.2015.04.008

Symptoms/signs suggestive of coagulopathy is a frequent complaint in Pediatric Hematology units. Both the clinical and family history are essential for diagnosis. Retrospective and descriptive study of patients referred to a Pediatric Hematology unit of a tertiary hospital for possible coagulopathy during 2012. A total of 47 children were studied, of whom 61.7% had not previously suffered bleeding. The most frequent reason for referral was an eloganted activated partial thromboplastin time without any hemorrhage (42.5%), of these, 25% were diagnosed of a coagulopathy with a real risk of bleeding. While patients referred due to an eloganted activated partial thromboplastin time with bleeding more frequently (41.7%) have a coagulopathy with a real risk of bleeding. Children with a family history of bleeding are diagnosed more frequently with a coagulopathy with a real risk of bleeding: 37.5% (family history) vs. 14.3% (without). The most frequent diagnoses were: healthy children (48.9%), von Willebrand type 1 disease (19.1%), factor xii deficiency (19.1%), factor xi deficiency (4.2%), prekalikrein/high molecular weight kininogen deficiency (2.1%), acquired deficiency of factor x (2.1%), and factor ix deficiency (2.1%). A thorough personal and family bleeding history and physical examination are the first steps for a correct differential diagnosis. The reason for referral should be based more on clinical bleeding and not just on an abnormal coagulation time. The most frequent diagnoses were type 1 von Willebrand disease and factor xii deficiency.