Management of coagulation disorders in children

Children may be born with an inherited coagulation disorder or can develop an acquired coagulopathy as a consequence of another disease or disorder. The correct diagnosis in either case is essential to appropriate management, to reduce the morbidity and mortality associated with inaccurate diagnosis or the incorrect treatment. The treatment of these disorders is often very expensive and there may be risks to the child associated with the administration of products used to treat coagulation disorders; these must be minimized when possible. For these reasons, the child may require referral to a tertiary specialist centre for further investigations and management. In children presenting with bruising or more severe bleeding manifestations, it is not uncommon for the first presumed diagnosis to be non-accidental injury, and it is essential that a true coagulation defect is excluded in these children.