Bleeding Disorders and Thrombosis

Bleeding Disorders

We specialize in treating several types of bleeding disorders in children and teens, including:

Hemophilia

Hemophilia is a bleeding disorder that is usually genetic. Children with hemophilia have little or no clotting factor VIII (Hemophilia A) or clotting factor IX (Hemophilia B). Children with hemophilia can experience spontaneous bleeding or bleeding with trauma in the joints. Bleeding can also occur in muscles, the mouth and nose, internal organs or in the brain. Without proper clotting factors, this can lead to complications like joint damage or even become life-threatening.

Von Willebrand disease

Von Willebrand disease is a bleeding disorder that is almost always inherited. Children with von Willebrand disease either have low levels of von Willebrand clotting factor or the clotting factor does not work as it should. Children with von Willebrand disease might experience nosebleeds, mouth bleeds, blood in their stool or urine, excessive bruising, heavy menstrual bleeding, increased bleeding after medical procedures and even bleeding joints, depending on the severity of von Willebrand disease.

Rare bleeding disorders

Children may also have other rare bleeding disorders where they're missing different clotting factors.

Platelet disorder

This is when the number of platelets (blood cells) are reduced, impaired or both. Depending on the severity, children can experience increased bruising, nosebleeds, oral bleeding, increased bleeding with medical procedures and even serious life-threatening bleeding.

Thrombosis

The three most common types of thrombosis in children are:

Thrombophilia

This is an inherited blood disorder. Children with thrombophilia have a greater risk of developing blood clots that spontaneously form in blood vessels.

Deep vein thrombosis (DVT)

This is a condition where poor blood flow causes a blood clot to form in a blood vessel, most commonly in the legs but also the arms. Children who have limited activity or movement (often because of illnesses like cancer, heart disease or lung disease) are at risk for DVT. These require prompt treatment to avoid blood clots traveling to the lungs.

Pulmonary embolism

If one of the pulmonary arteries or branches in your lungs is blocked, it’s called a pulmonary embolism. It’s caused by a blood clot that travels from a lower part of the body, like an extremity (arm or leg) to the lungs. If the clot blocks blood flow to your child’s lungs, this could be serious.

Bleeding disorder symptoms

Symptoms of bleeding disorders include:

• Excessive or long-lasting bleeding with minor wounds or trauma
• Several or large bruises
• Heavy periods in girls
• Frequent or long-lasting nosebleeds
• Blood in stool or urine
• Mouth or gum bleeding or long-lasting bleeding when losing a tooth
• Warmth, swelling, pain or decreased range of motion in the elbows, knees and ankles
• Warmth, swelling, pain in the arms and legs
• Excessive or long-lasting bleeding after surgeries
• Headaches, vomiting, weakness or change in alertness

It’s especially important to watch for these symptoms in your child if your family has a history of bleeding disorders.

Thrombosis Symptoms

Many children with thrombosis have no symptoms, but if a child is at risk because of family history or a chronic disease, parents should watch for:

• Pain
• Swelling
• Tenderness
• Redness and warmth of the skin
• Chest pain or shortness of breath
• Headaches, vision changes, vomiting or change in alertness

If your child has a bleeding disorder or thrombosis, it’s important to diagnose the disorder promptly and accurately.

Diagnosis Bleeding Disorders

If your child has symptoms of a bleeding disorder, your child’s doctor likely will conduct a thorough physical exam and ask about your child’s medical history and your family’s history of similar disorders. Doctors might order blood tests, which can determine:

• How long it takes your child’s blood to clot
• If your child’s blood is missing or has reduced clotting factors
• If your child’s blood has dysfunctional clotting factors

Diagnosis of Thrombosis

Left untreated, thrombosis can lead to serious and life-threatening complications. Your child’s doctor will do a thorough physical exam and ask about your child’s medical history and your family’s history of similar disorders, in addition to:

• Blood tests: To test your child's blood to see if they're missing clotting factors or have other substances in their blood that indicate a blood disorder
• Ultrasound: A test that uses sound waves to take pictures of blood flowing through the arteries and veins
• CT scan: A test that uses X-rays to take pictures of your child’s organs and tissues
• MRI: A test that uses magnetic fields to produce images of your child’s organs and tissues
• Venography: A test that injects dye into a vein to make it visible on an X-ray

Treating Bleeding Disorders

Medications can help kids with conditions like hemophilia or von Willebrand disease manage their bleeding disorder. These therapies are designed to control or prevent bleeding by replacing missing or dysfunctional clotting factors and stimulating the release of more clotting factors.

Treating Thrombosis

Your child’s doctor will recommend treatment for thrombosis based on risk for complications. This includes:

• Anticoagulants: Medications that thin the blood, helping the blood flow more easily
• Thrombolytics: Medications that dissolve blood clots
• Compression stockings: Tight stockings that keep blood from pooling and clotting and reduce swelling from blood clots
• Thrombectomy: Surgical procedure that involves removing blood clots from arteries or veins