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BACKGROUND
A 4-year-old girl of mixed race origin presented with a 1-month history of spontaneous bruising and occasional gum bleeding raising concerns of non-accidental injury (NAI). There was no family history of bleeding tendencies. She was admitted for further investigations.
Examination revealed a thriving girl with multiple bruises over her lower limbs. (figures 1 and 2). There was no hepatosplenomegaly or lymphadenopathy.
Her initial full blood count is as follows: haemoglobin 12.1 g/dL, total white blood cell count 14.72x109/L (neutrophil 38%, lymphocyte 29%, monocyte 3%, eosinophil 28% and absolute eosinophil count 4.1x109/L). Her platelet count was slightly low at 135x109/L. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were normal.
QUESTION 1
Apart from investigating for NAI, what features on investigation would distinguish between the differentials below?
Immune thrombocytopenic purpura (ITP).
Congenital platelet disorders.
Acquired platelet dysfunction disorders. …
Footnotes
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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