Children commonly have small bruises due to falls and accidents. Easy bruising, however, might indicate a medical problem.
Bruises are hardly unusual in children as they tend to fall, run into each other and bump the furniture regularly. But bruising that occurs spontaneously or seems out of proportion to an injury should be evaluated. Many conditions and diseases can cause easy bruising in children. Some are temporary and pose no long-term health threat while others require ongoing medical management. See your doctor for an accurate diagnosis if your child experiences easy bruising.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Platelets, or thrombocytes, are cellular fragments that circulate in the blood and stick together at the site of an injury to stop bleeding. With immune thrombocytopenia (ITP), the blood platelet level is low while other blood cell levels are normal in an otherwise healthy child. The reduced number of platelets frequently leads to easy bruising and possibly a tendency to bleed more easily and longer than normal. Childhood ITP most commonly develops after a viral infection, which is thought to trigger a misguided immune response that leads to increased platelet destruction, decreased production or both.
In most children with ITP, the platelet count returns to normal within 6 months without complications. Many doctors do not treat the condition with medication unless the child experiences serious bleeding, which rarely occurs. During the watchful waiting period, it's important to take precautions -- such as avoiding contact sports and protecting the head with a helmet -- to prevent injuries that might lead to serious internal bleeding.
Genetic Bleeding Disorders
Platelets work hand-in-hand with 13 proteins called clotting factors to stop bleeding after an injury. Children with genetic clotting factor deficiencies typically exhibit easy bruising and bleeding of varying severity. The most common of these disorders is von Willebrand disease, which affects approximately 1 percent of the US population, according to the Centers for Disease Control and Prevention 3. The disease affects males and females equally, and symptoms are usually mild to moderate.
Hemophilia is much less common than von Willebrand disease and almost exclusively affects males. Most people with hemophilia experience moderate to severe symptoms, including bruising and spontaneous bleeding. Most children with hemophilia receive clotting factor infusions to prevent bleeding into the joints and other areas of the body.
Other genetic clotting disorders have been identified but are extremely rare. Blood tests are used to distinguish among the different types of these bleeding disorders.
Bone Marrow Disorders
- Vitamin B12 and/or folate deficiency
- Bone marrow failure syndromes
- Inherited platelet disorders :
- Certain medications, such as:
- bacterial meningitis
coli_ food poisoning
- High fever
- Neck stiffness
- Confusion, agitation or drowsiness
- Dizziness or fainting
- Severe or worsening abdominal pain :
Many conditions and diseases can cause easy bruising in children. Other conditions and disorders can reduce bone marrow platelet production, such as: * Vitamin B12 and/or folate deficiency
Bone marrow failure syndromes Inherited platelet disorders Easy bruising in children can occur due to a variety of other causes. The reduced number of platelets frequently leads to easy bruising and possibly a tendency to bleed more easily and longer than normal.
- The Ochsner Journal: Management of Immune Thrombocytopenic Purpura -- An Update
- Practical Pediatric Hematology, 2nd Edition; Anupam Sachdeva
- Centers for Disease Control and Prevention: Von Willebrand Disease (VWD)
- Elsevier's Integrated Review Genetics, 2nd Edition; Linda R. Adkison
- American Cancer Society: Cancer Facts and Figures 2017
- American Family Physician: Clinical Evaluation of Bleeding and Bruising in Primary Care
- British Journal of Haematology: Bruising and Bleeding in Infants and Children – A Practical Approach