Severe recurrent epistaxis in children: A case report involving two complex underlying conditions

Epistaxis is very frequent in pediatrics affecting almost 60% of children. It is generally a benign condition, but occasionally an underlying disease such as a systemic coagulopathy or a local tumor may be present. We report a case of a child with severe recurrent epistaxis, in whom both a mild platelet function disorder (PFD) and an intranasal infantile hemangioma (IH) were diagnosed after several diagnostic efforts. Both conditions acted synergistically in the genesis of epistaxis. PFD involves a group of hereditary defects of primary hemostasis that are frequently under-diagnosed. IH is the most common tumor of childhood and is preferently localized in the head and neck areas causing unilateral epistaxis when located in the nose. We address the place of complementary hematological or local evaluations in children presenting severe recurrent epistaxis.