Bruising: When it is spontaneous and not idiopathic thrombocytopenia purpura

Abstract

Bruising is a presentation that often causes concern. There are many causes of bruising in children, including non-accidental injury, which must be excluded. We report a case of a 22-month-old boy where all the common diagnoses were excluded. We highlight the need to be aware of transient acquired inhibitors of coagulation that can cause spontaneous bleeding.

Lupus anticoagulant acquired hypoprothrombinemia syndrome in childhood: two distinct patterns and review of the literature

“…A total of 34 articles including case reports, case series and letters to editors between 1960 and 2014 were reviewed ( Table 2) [1][2][3][4][5][6][7][8][9][10][11][12][13]15,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Fifteen case reports [6,8,13,[17][18][19][20][21][22][26][27][28][29][30]36] and 5 case series [1,...…”

Challenging hemostasis scenarios in pediatric patients – two case studies

“…Recent antecedent infection is an important risk factor, particularly in pediatric patients. Commonly associated infections include adenovirus (most commonly implicated), Epstein–Barr virus, and cytomegalovirus . Other risk factors include associated autoimmune disease (particularly systemic lupus erythematosus), medications, and lymphoproliferative disorders .…”

“…Based on the available evidence, it remains poorly defined why some patients with LA‐HPS bleed and some do not. The severity of hypoprothrombinemia alone in the setting of LA‐HPS cannot predict bleeding risk .…”

“…Although LAs are not generally associated with bleeding, concomitant hypoprothrombinemia is one of the few clinical situations in which LAs may be associated with clinical bleeding. Other situations include significant concurrent thrombocytopenia, or a concomitant factor VIII inhibitor .…”

“…In exceptional cases, bleeding may present with sudden and possibly fatal hemorrhage. Bleeding may be provoked, such as bleeding seen perioperatively, or may be spontaneous .…”