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Q. Nose bleeding-what could be the major cause?

Answered by
Dr. Veerendra Channabasappa Patil
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 16, 2015 and last reviewed on: Feb 05, 2019

Hi doctor,

My daughter is 9 years old. She gets nose bleeding once in few months and also gum bleeding. She complains about occasional back pain, stomach burning, and hip pain too. My family physician has written down a series of tests and asked me to get opinions from a hematologist, gastroenterologist, and an orthopedic doctor respectively.

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#

Hi,

Welcome to icliniq.com.

From the medical history of your child, I can understand that she is having bleeding manifestations with normal CBC (complete blood count) and coagulation workup. I would like to know about the below-mentioned questions,

  1. Since when does your daughter experience the bleeding manifestation?
  2. Any of your family members have a similar history in their past?
  3. Does she take any chronic medication for pain?

The most common bleeding disorder is a condition known as Von Willebrand disease. I think she needs to be checked for it and the other condition which needs to be evaluated is platelet dysfunction. Investigations suggested are,

  1. VWF: Ag (Von Willebrand Factor Antigen) assay.
  2. VWF: RiCof assay (Von Willebrand Ristocetin Cofactor).
  3. Platelet aggregation assay.

Hi doctor,

Thank you for your response. She has been having the nose bleeding since 4 years. It occurs 3 or 4 times a year. Mostly when her nose is dry, or she gets cold. During that time she might have the bleeding episode 2 or 3 times for that particular phase. My husband's brother has nose bleed since he was a child. She is not on medication for pain. I can get the tests done and revert back to you.

#

Hi,

Welcome back to icliniq.com.

Bleeding from nostril can be due to local causes but as you have mentioned that she also had gum bleeding, it makes her to be evaluated further for the bleeding diathesis. You can go ahead with the investigations.


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