A 4
year-old boy presented with a marked bruising tendency of the arms and
legs. His mother mentioned that the
bruising typically appeared without injury.
Past
medical history revealed that at 3 years of age the patient had an episode of
epistaxis that required transfusion of one unit of blood.
There
was a family history of bleeding on the maternal side of the family. The patient’s mother and maternal grandmother
had abnormal bleeding characterized by recurrent epistaxis and menorrhagia. The patient’s mother was transfused with 5
units of blood at the time of his delivery.
The
patient was on no medication at the time of evaluation.
Physical
examination revealed multiple ecchymoses over the extremities.
PT=
10 sec (Normal 8-11.5)
aPTT= 39 sec (Normal 24-37.5)
Plt=
250,000 /μL (Normal 150,000-350,000)