Common Bleeding Disorders in Children Symptoms and Treatment

Common bleeding disorders in children

Our body has several important mechanisms to prevent excessive bleeding when we get injured. However, some children are born with an inherited disorder that can cause mild to severe bleeding after injuries or surgery. This happens because their blood does not clot properly. Such bleeding disorders interfere with the body’s normal clotting process, which is called coagulation.

What are the symptoms of bleeding disorders in children?

Bleeding symptoms in children with bleeding disorders can range from mild to severe.

Mild bleeding disorders

Easy skin bruising or bleeding from the nose or gums are common symptoms in children with mild bleeding disorders. Teenagers may experience menorrhagia. Some children with mild bleeding disorders may suffer from severe bleeding following surgeries or injuries.

Severe bleeding disorders

Bruising and excessive bleeding may occur at or shortly after birth in children with severe bleeding disorders. In these children bleeding can  occur from any site, even with trivial trauma/injury ,sometimes could to be an extent of life threatening event.

What are the most common types of bleeding disorders in children?

The two most common types of bleeding disorders are hemophilia and von Willebrand disease.

What Is Hemophilia?

A bleeding disorder called hemophilia occurs when one of the clotting factors is either absent or reduced. Since the condition is hereditary, it is passed from parent to the child. But some children with hemophilia might not have any family history of the condition, as it would have been asymptomatic or undiagnosed.

There are two types of hemophilia:

Hemophilia A: The most prevalent type, caused by a factor VIII deficiency

Hemophilia B: Less common than hemophilia A, hemophilia B is caused by a factor IX deficiency.

Hemophilia can be classified as mild, moderate, or severe according to the blood's clotting factors:

Mild: Children with over 5% of the factor levels

Moderate: Children with factor levels ranging from 1% to 5%

Severe: Children lacking either factor VIII or factor IX

Hemophilia Treatment in Children

Treatment options are based on the type and severity of  child's hemophilia.

Antifibrinolytic medications: These can strengthen the blood clots. They can be used to alleviate mouth or nose bleeding or after dental operations.

Desmopressin: This medication helps in the body's secretion of factor VIII. Mild bleeding episodes can be treated with this medication.

Emicizumab: An injectable drug used to treat hemophilia A in children. It is a wonder drug which can significantly reduce the bleeding episodes in children.

Factor replacement therapy: Concentrated forms of factors VIII (for hemophilia A) and IX (for hemophilia B) can be administered intravenously to children with moderate to severe hemophilia.

What is von Willebrand disease?

Von Willebrand disease (vWD) is a group of bleeding condition caused by either  deficiency or improper functioning  of von Willebrand factor (vWF), a blood clotting protein. The pattern of inheritance is majorly autosomal dominant. Accordingly, each child has a 50% chance of inheriting vWD if one parent has it.

Type 1 vWD is the most prevalent hereditary form of vWD, accounting for 1% of general population. A child with type 1 vWD has less than the  normal  % of  vWF in their blood.

Other forms of vWD are less common. A child with type 2 vWD may have appropriate levels of vWF in their blood, but it isn't functioning properly. A child with type 3 vWD does not have vWF in their blood. The type 3 vWD is the rare type, but causes the most serious bleeding problems.

How is von Willebrand disease treated?

Fortunately, most children born with vWD experience only mild and infrequent bleeding episodes, so regular medication is usually not required. However, some adolescents and adults who menstruate may have heavy periods that need to be managed with hormonal treatment and other supportive care.

The medicines used to prevent or control bleeding after surgeries, dental procedures, or injuries in children with vWD depend on the type of vWD and the severity of symptoms.

Many children with Type 1 vWD who have bleeding issues can be treated with a medication called desmopressin, which may be given through an injection under the skin, into a vein, or as a nasal spray. This medicine helps release stored vWF from the lining of blood vessels, aiding in clot formation. Desmopressin can also benefit some children with Type 2 vWD.

Another treatment option involves replacing the missing or defective vWF through an intravenous infusion of vWF concentrate derived from donated blood plasma. This therapy is effective for all individuals with Type 3 vWD and for some with  Type 2. Additionally, a new recombinant (genetically engineered) vWF concentrate is being developed as an alternative to plasma-based products.

What if my child has symptoms or episodes of abnormal bleeding?

For a comprehensive assessment, contact your pediatrician if your child shows  bleeding symptoms at any age. If your child experiences significant bleeding, try to stop it by applying pressure and reach out to your pediatrician immediately.

Most children who exhibit severe bleeding symptoms will need to consult a pediatric hematologist. The evaluation process includes a detailed personal and family history, a physical examination, and specialized blood tests to determine the underlying cause of the bleeding.

Why Choose Ankura Hospital for Your Child's Care?

We at Ankura Hospital for Women and Children understand that every child deserves specialized care, especially when it comes to conditions like bleeding disorders. To keep your child safe and healthy, our pediatric oncologists and hematologists are skilled in providing precise diagnoses, customized treatment plans, and compassionate care.

With state-of-the-art diagnostic facilities, advanced laboratories, and round-the-clock emergency support, Ankura Hospital offers a comprehensive approach to managing both mild and severe bleeding disorders. We focus on early detection, preventive care, and effective treatments that help your child lead a healthy, active life.