Frequency and Etiology of Nosebleeds among Children in Pediatric Out-Patient Clinic of Ain Shams University Hospitals

Abstract

Abstract Aims Measure frequency, severity, and etiology of epistaxis in a tertiary center pediatric out-patient clinic. Population Pediatric patients presented with epistaxis of an unknown cause. Methods Thorough clinical assessment, ENT examination CBC and coagulation profile and confirmatory tests when needed. Results 100 patients with epistaxis (53 females and 47 males) were recruited out of 30043 visits to pediatric OPC throughout one year (1 in 300). Most of them were younger than 12 and nearly half of them were younger than 6 years. 43 patients had epistaxis only, most probably local bleeding (37 had idiopathic epistaxis, 6 had local ENT cause). 57 had other bleeding manifestations, most probably systemic bleeding (47 had a definite bleeding disorder and 10 had undiagnosed bleeding tendency). There was a statistically significant higher number of patients with a positive family history for epistaxis and being referred from a primary care physician in those with probably systemic cause. Conclusion Epistaxis is not uncommon, it is not always idiopathic and can be the presenting symptom for an underlying bleeding tendency.