My daughter gets bruises on her legs without any injury. Why?

Question

Hi doctor,

This query is regarding my 8-year-old daughter. She has been constantly getting bruises on her legs. We think this bruise occurs automatically and may not be due to injury. We have been noticing these bruises for the past 6 to 7 years. It fades away automatically after few days. We consulted a pediatrician, a physician, and a dermatologist. All of them did not have a diagnosis. The dermatologist just gave vitamin C tablets. We took a blood test during the last time we saw such a bruise mark, on the request of a pediatrician. I have attached this blood report. I have also attached a photograph of the bruise.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen the attached reports (attachment removed to protect patient identity). Your description of the symptoms of your child seems to be significant, as the bruises are spontaneous. I would be interested to know the following points.

Was there any swelling at the injection site during vaccination in her infancy?
Are there any other bleeding manifestations other than bruises? Like, bleeding from the nose, gums, excess bleeding following trivial injury, etc.
Anybody else in your family having similar bleeding problems?
Does your child complain of joint pains?

I would be interested in ruling out bleeding disorder, and for that, I need your answers for the above questions.

Answer 2

Hi,

Welcome back to icliniq.com.

I would suggest you do some blood investigations as follows, to rule out bleeding disorder.

PT (partial thromboplastin) and APTT (activated partial thromboplastin time).
vWF: Ag assay (von Willebrand antigen assay).
vWF: RiCof assay (von Willebrand Ristocetin cofactor assay).
Platelet function studies.
ANA (antinuclear antibody).

My daughter gets bruises on her legs without any injury. Why?

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