Micro-Hemmorage in 8 yr old *No head trauma*

[jensasweetie]

My daughter was seen for her first eye check and it was found that she has 4 'significant' bleeds.  They have said they would have occur in the last couple weeks, 6-8 at the outset.  She has had no type of head injury or any of any kind actually within the last year.  She is having no symptoms of visual disturbances and is behaving normally.  A CT performed yesterday was normal along with a battery of blood test to rule out the obvious blood disorders.  I assume the genetic anemia (i'm sorry dont know all the blood work)  As far as blood sugar levels, she is actually on the hypo end of the scale not hyper as her fasting was 79.  In all other ways she has been normal other than, in a huge sidenote, she passed a clot vaginally approx 4 weeks ago as well as had blood in her urine following this days later.  All test performed as of date have been normal like I said.  Her list of doctors is increasing as no one can seem to pinpoint what could be the problem causing this.  I live in a small town (pop 20,000), they are consulting Children's in Seattle to no avail at this point for conclusive answers.  

I thought i would post in the event someone could think of something as her doctors are open for suggestions as they are confused and are looking for other avenues and tests to come up with a direction to go.

Thanks for any help you can give us !

Jen

[Michael J Kutryb, MD]

There could be some type of bleeding disorder so she needs to see a hematologist at a teaching hospital.  I am quite concerned about these findings.  If no blood clotting disorder is found,  you would need to really look closely into some type of trauma that could have occured that you don't know about.  Basically those are the two possibilities that come to my mind: bleeding disorder and blunt trauma.

MJK MD

[jensasweetie]

Thank you so much for taking the time to answer me.  This is quite troubling as you can well imagine.  I live in Pullman at Washington State Univ.  The nearest cities are Spokane, Boise, and Seattle.  Do you have suggestions on how to go about this.

As far as accidents or trauma, she only plays at 2 other girl's houses.  I have talked extensively to the parents of both and nothing other than a slip out of a hammock has happend.  This I don't believe could cause this type of trauma.  As far as blood disorders, she doesn't have the obvious clotting problem as far as the reults from yesterdays labs.  I believe they may have tested for indication of Lukemia;  like I mentioned before, all her work has come back normal.  There also is no genetic history.

As far fetched as this is, she did have an accident 13 months ago, where she fell off the monkey bars.  She received a compression fracture in T7 i believe.    She also had an accident 17 months ago when a boy kicked back at her and her finger then had a hairline fracture.  To me with common sense leads me to wonder about her bone cell and blood quality as far as diseases.

Her doctor is somewhat at a loss as far as what to do next.  He is older but in a large practice.  He is very proactive, but is at the point where any suggestions would be greatly appreciated.

Thank you for your time.

Jen

[Michael J Kutryb, MD]

A hematologist would be able to answer those questions.

MJK MD

[jensasweetie]

Hi...thanks for your input.  I actually have had her to a pediatric optho which found that the bleeds had healed or were gone.  Interesting.  They are going to do tests for the other things in her body and he is calling a retinal specialist in Portland.  All test have come back fine, so we have a positive outlook, just need to verify the other organ systems are ok.  I will leave a message of any findings for a FYI.  

Thank you again for taking the time with us.

Jen