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Year : 2014  |  Volume : 30  |  Issue : 2  |  Page : 106-111

Recurrent epistaxis in children: When should we suspect coagulopathy?

1 Department of Pediatrics, Kasr El Aini University Hospital, Cairo University, Cairo, Egypt
2 Department ofOtolaryngology Head and Neck Surgery, Kasr El Aini University Hospital, Cairo University, Cairo, Egypt
3 Department of Pediatrics, Ministry of Health, Egypt

Correspondence Address:
Hesham Fathy
22 Montaza street, Heliopeles, 11351, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1012-5574.133207

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Objective The objective of this study was to evaluate children and adolescents with recurrent epistaxis and to spot variables that may predict underlying bleeding disorder. Study design This was a prospective study. Materials and methods Thirty-six children with recurrent epistaxis were recruited from ENT outpatient clinic as well as emergency room of Cairo University children hospital. Patients with systemic causes for epistaxis were not included. All patients were subjected to basic workup to differentiate between ENT and hematological causes of epistaxis. Accordingly, extended ENT investigations or coagulation studies were performed. Results Results showed 47.6% incidence for bleeding disorders, 39.7% incidence for ENT causes, and 12.7% incidence for idiopathic causes. Reported coagulopathies included idiopathic thrombocytopenic purpura with an incidence of 26.7%, platelet functions disorders such as Glanzmann's thrombasthenia (13.3%) and Bernard-Soulier syndrome (10%), aplastic anemia (3.3%), hemophilia A (3.3%), Von Willebrand disease (3.3%), and unclassified (40%). Reported local ENT causes included bacterial rhinitis (88%) (lodged foreign body was found in 1/3 of these patients, digital trauma by habitual nose picking was detected in another 1/3, and the remaining 1/3 represented cases of complicated previous viral rhinitis), nasal allergy (8%), and adenoid (4%). Conclusion The study recommended some statistically significant predictors for bleeding disorders such as positive consanguinity, high epistaxis bleeding score, presence of other bleeding sites, low hemoglobin level and platelet count, and elevated activated partial thromboplastin time.

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