Child with multiple ecchymoses … is it abuse?
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v24.i1.8577Keywords:
Child abuse, bleeding disorder, ecchymoses, von Willebrand diseaseAbstract
Case report: Child abuse is a public health problem; bleeding disorders can mimic some of these situations. We alert to this problem reporting a case of suspected child abuse in a toddler with multiple ecchymoses. The history and clinical evaluation, including coagulation tests, achieved the diagnosis of severe type I von Willebrand disease failing to prove social dysfunction.
Comments: Physical abuse suspicion in children with bruising symptoms should raise the concern of a potentialbleeding disorder. Laboratory tests should be done on the basis of patient and family history, physical examination and prevalence of bleeding conditions. Nonetheless, laboratory testing indicating the presence of a bleeding disorder does not exclude concomitant child abuse and social monitoring and vigilance should be maintained.
Downloads
References
United Nations. World report on violence against children. 2006. Acessível em: http://www.who.int
Leça A, Perdigão A, Laranjeira A, Menezes B, Velez C, Prazeres V, et al. Maus tratos em crianças e jovens- guia prático de abordagem, diagnóstico e intervenção. Direcção Geral Saúde; Fevereiro 2011. Acessível em: http://www.dgs.pt -Microsite Crianças e
Jovens em Risco.
Comissão Nacional de Proteção das Crianças e jovens em Risco. Relatório anual da avaliação da actividade das Comissões de Proteção de Crianças e Jovens no ano de 2013. Acessível em: http://www.cnpcjr.pt/
Anderst JD, Carpenter SL, Abshire TC, Section on Hematology/Oncology and Committee on Child Abuse and Neglect of the American Academy of Pediatrics. Evaluation for bleeding disorders in suspected child abuse. Pediatrics 2013;131(4):e1314–22.
Laposata ME, Laposata M. Children with signs of abuse: when is it not child abuse? Am J Clin Pathol 2005;123(1):S119-24.
Carpenter SL, Abshire TC, Anderst JD, Section on Hematology/ Oncology and Committee on Child Abuse and Neglect of the American Academy of Pediatrics. Evaluating for suspected child abuse: conditions that predispose to bleeding. Pediatrics 2013;131(4):e1357–73.
Montgomery RR, Gill JC, Di Paola J. Hemophilia and von Willebrand disease. In: Nathan and Oski’s: Hematology of Infancy and Childhood, 6th ed. Philadelphia. Saunders Elsevier; 2003. p. 1487- 524.
Lillicrap D. von Willebrand disease: advances in pathogenetic understanding, diagnosis and therapy. Blood 2013;122(23):3735-40.
Sousa LA, Ferrão A, Morais A. Doença de von Willebrand: dificuldades no diagnóstico. Acta Pediatr Port 2006;37(4): 158-61.
Downloads
Published
How to Cite
Issue
Section
License
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.
