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Lisa Black

The American Academy of Pediatrics provides guidance on when and how to evaluate for bleeding disorders in children who have bruising or bleeding that is concerning for abuse. in two reports published in the October 2022 Pediatrics (published online Monday, Sept. 19). A clinical report, “Evaluation for Bleeding Disorders in Suspected Child Abuse,” observes that many bleeding disorders are rare but that in some instances, bleeding disorders can present in a manner similar to child abuse. An accompanying technical report, “Evaluating for Suspected Child Abuse: Conditions That Predispose to Bleeding,” provides data supporting recommendations that distinguish abusive from accidental bruising and that characterize bruising in children with congenital bleeding disorders. Both reports were written by the AAP Section on Hematology/Oncology and the AAP Council on Child Abuse and Neglect. Recommendations include checking the patient’s medical and family history of bleeding or bruising, along with physical examination findings, before initiating laboratory tests. The clinical report details various bleeding disorders, the prevalence of the condition and how to determine the potential of each specific condition to cause a specific finding in a given child. The AAP notes that laboratory testing suggesting or indicating the presence of a bleeding disorder does not eliminate abuse from consideration.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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