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Severity and Features of Epistaxis in Children with a Mucocutaneous Bleeding Disorder

Lookup NU author(s): Dr Tina Biss


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© 2017 Elsevier Inc. Objective: To use standardized bleeding questionnaires to compare the severity and patterns of epistaxis in children with a mucocutaneous bleeding disorder and control children. Study design: The epistaxis sections of the Pediatric Bleeding Questionnaire (PBQ) administered to pediatric patients with von Willebrand disease or a platelet function disorder and healthy control children were reviewed. Scores and features of epistaxis (frequency, duration, onset, site, seasonal correlation, and need for medical/surgical intervention) were recorded. A PBQ epistaxis score ≥2 was defined as clinically significant. The Katsanis epistaxis scoring system was administered to eligible patients, ie, with ≥5 episodes of epistaxis per year. Results: PBQ epistaxis scores were obtained for 66 patients, median age 12 years (range 0.6-18.3 years), and 56 control children. The median PBQ epistaxis score in patients was 2 vs 0 in control children (P <. .0001). All of the features of epistaxis, except spontaneous onset, occurred in a significantly greater proportion of patients than control children with epistaxis. A total of 50% of the patients were graded as having severe epistaxis by the Katsanis epistaxis scoring system, and 30 of these (91%) had a clinically significant PBQ epistaxis score. Conclusion: Standardized bleeding questionnaires are useful in the assessment of epistaxis severity and pattern and may help to distinguish children with and without a mucocutaneous bleeding disorder.

Publication metadata

Author(s): Stokhuijzen E, Segbefia CI, Biss TT, Clark DS, James PD, Riddel J, Blanchette VS, Rand ML

Publication type: Article

Publication status: Published

Journal: Journal of Pediatrics

Year: 2018

Volume: 193

Pages: 183-189.e2

Print publication date: 01/02/2018

Online publication date: 01/12/2017

Acceptance date: 28/09/2017

ISSN (print): 0022-3476

ISSN (electronic): 1097-6833

Publisher: Mosby Inc.


DOI: 10.1016/j.jpeds.2017.09.082


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