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Occasional bloody nose, low grade fevers, bruise on flank area

I was wondering if I should be concerned that my daughter has had an occassional bloody nose since the end of January, low grade fevers (99.8-100.8) on and off without any s/s of infectious cause (no runny nose, congestion, or cough or n/v or diarrhea ), and last week she had a large bruise that appeared without regard injury to her left flank area, the bruise was not tender, in fact, she was indifferent to it when touched. She seems to act okay during the day, but her sleeping patterns have changed at night.
Asked On : Fri, 16 Mar 2012
Answers:  1 Views:  88
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Diseases and Conditions
Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
A history of bleeding from nose and spontaneous bleeding in the flank region suggests a platelet disorder.
Platelets are blood cells which are responsible for formation of plugs which stop bleeding from blood vessels after minor injury to small blood vessels.
When there is decrease in number of platelets or any abnormality in the function of the platelets, they are not able to perform their function of making a platelet plug and stop spontaneous bleeding.
However, platelet abnormalities cause petechial hemorrhages (pin point hemorrhages). Large sized bruises are caused by abnormalities of coagulation factors.
You need to consult a hematologist for clinical examination of the child, platelet function tests and thus management.
Platelet abnormalities are treated by platelet transfusion whereas coagulation factor defects are treated by replacement of coagulation factors.

Thanks and take care
Dr Shailja P Wahal

Answered: Sun, 10 Nov 2013
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