Severe bleeding disorders in children with normal coagulation screening tests.

Lesson of the WeekSevere bleeding disorders in children with normal coagulation screening tests G P TAYLOR Congenital bleeding disorders may present in many ways, usually doing so in infancy or early childhood.In any child pre- senting with unexplained bruising one must also consider the possibility of non-accidental injury.In many cases it may be impossible to exclude non-accidental injury because the history and signs may only be pointers, the true facts becoming apparent only by careful follow-up.I report on two children in whom the diagnosis of possible non-accidental injury, along with "normal clotting studies," led to delayed diagnosis of congenital bleeding disorders.