Blutungsneigung und ihre Abklärung bei Kindern und Jugendlichen

Bleeding in the form of hematoma, petechiae, nose bleeds or heavy menstrual bleeding, occur relatively frequently in children and adolescents. Bleeding is rarely dangerous and only infrequently caused by an inherited bleeding disorder. Through a standardized patient history, a detailed clinical examination and preliminary laboratory diagnostics, threatening systemic diseases, such as acute leukemia or sepsis should initially be ruled out. This is followed by a rough differentiation into plasmatic, thrombocytic or vasogenic coagulation disorders, based on the patient history and the clinical examination. In these cases, targeted coagulation diagnostics should be performed in order to rule out or to confirm a coagulation disorder. Important differential diagnoses of plasmatic coagulation disorders include von Willebrand disease and hemophilia A and B. A frequent cause of a thrombocytic coagulation disorder is immune thrombocytopenia. In cases of a vasogenic coagulation disorder an IgA vasculitis should be ruled out.