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Excluding medical and haematological conditions as a cause of bruising in suspected non-accidental injury
  1. A M B Minford1,
  2. E M Richards2
  1. 1Department of Paediatrics, Bradford Royal Infirmary, Bradford, UK
  2. 2Department of Paediatric Haematology and Oncology, St James University Hospital, Leeds, UK
  1. Adrian M B Minford, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK; adrian.minford{at}sky.com

Abstract

A mistaken diagnosis of child abuse can occur in a number of medical conditions, many of which can be readily diagnosed by experienced paediatricians. Bleeding disorders offer a greater challenge, especially when court proceedings may demand their exclusion. Some of these disorders are rare but more prevalent in areas which have a high incidence of consanguinity. We advocate two stages of laboratory investigations but the limitations of some of these tests and their inability to exclude a bleeding disorder with absolute certainty should be recognised. However, if personal and family histories are absent and both first-stage and second-stage investigations are normal, it is highly unlikely that a bleeding disorder will be missed.

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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