The presentation of a child with easy bruising can be alarming for both parents and practitioners alike. In many cases, blood counts, blood film and coagulation screening are the appropriate investigations to confirm diagnosis.
- Causes of easy bruising in childhood include platelet disorders (e.g. idiopathic thrombocytopenic purpura) and deficiency of haemostatic factors (e.g. von Willebrand’s disease and the haemophilias).
- Other causes that do not primarily involve haemostasis, such as nonaccidental injury, malignancy and meningococcal infection, must not be overlooked in the child with easy bruising.
- A detailed history, including a family history, a physical examination and an understanding of the haemostatic process, provide the basis for clinical diagnosis.
- Simple tests, including full blood count, blood film and coagulation screen, are usually the most appropriate initial investigations to confirm diagnosis and guide management.