Bleeding Disorders in Pediatrics

A common practice among primary care providers is to order a complete blood count (CBC) when patients present with symptoms that may point to a bleeding disorder. Abnormal results, such as a very low or very high platelet count, may cause concern and prompt providers to call or refer their patient to a specialist.

A detailed history of the child’s symptoms and critical evaluation of cell lines in the CBC lab results can provide vital information about which bleeding disorder, if any, the child may have.

Listen to a pediatric hematologist discuss his approach to bleeding disorders in children

In this season’s kick-off episode, we discuss the most common bleeding disorders in pediatrics through the lens of the CBC with Taizo Nakano, MD. Dr. Nakano shares some of the ways he responds to calls about CBC results.

Dr. Nakano is the Medical Director of the Vascular Malformation and Tumor Center at Children's Hospital Colorado and is Assistant Professor of Pediatrics of Hematology/Oncology and Bone Marrow Transplant at the University of Colorado School of Medicine.

In this episode, our expert discusses:

• Why higher platelet counts are more worrisome
• The importance of establishing whether symptoms are acquired or congenital
• Some of the common reasons why platelet counts can increase significantly
• Considering production, destruction or bleeding when diagnosing issues with red blood cells
• Consulting with a gastroenterologist when providers can’t trace blood leakages
• Doing a mean corpuscular volume (MCV) and red blood cell count (RBC) as the next step after a CBC in anemic patients
• Why the reticulocyte count test is the best indicator of what is happening in the bone marrow
• The difference between a primary and secondary polycythemia
• Keeping in mind the environmental factors that could play a role in high red blood cell count
• How to approach newborns with unusual levels of hemoglobin
• History, context, duration of problem and age as primary factors to consider in leukopenia
• Distinguishing between leukopenia and neutropenia
• Physical symptoms to consider in neutropenia: sites of infection, abscesses and oral ulcers
• Anti-seizure medication and when moderate neutropenia can be tolerated
• Considerations before treating patients with a high white blood cell count

Treatment of pediatric bleeding disorders at Children’s Colorado

Pediatric hematologists in the Hematology Program at Children’s Colorado have internationally recognized expertise in hemophilia, bleeding and clotting disorders, hematological diseases and immuno-hematological diseases. Our doctors are also leading researchers in their field and have published groundbreaking research about the care and treatment of babies, kids and young adults with blood and clotting disorders.