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What are the main causes of nosebleeds?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

My daughter is 9 years old. She gets nose bleeding once in a 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.

Kindly guide.

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 following questions,

  1. Since when has your daughter experienced the bleeding manifestation?
  2. Do 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's 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.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Thank you for your response.

She has been having nosebleeds for four years. It occurs three or four times a year, mostly when her nose is dry or she gets a cold. During that time, she might have bleeding episodes two or three times for that particular phase. My husband's brother has had nosebleeds 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 the nostrils can be due to local causes, but as you have mentioned that she also had gum bleeding, she should be evaluated further for the bleeding diathesis. You can go ahead with the investigations.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.

Medically reviewed byiCliniq medical review team

Published At October 16, 2015
Reviewed AtNovember 18, 2025

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