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DR. Kumar,

Thank you very much for your time.  A student in my class cut her finger (pinkie finger) on a pencil sharpener today.  We applied a band aid and didn't think much about it until she took off the band-aid about an hour and a half later.  It was bleeding so we took her to the school nurse.  The nurse cleaned it and applied a new band-aid.  About another hour and a half later she took off her band-aid before leaving on the bus and her finger was bleeding enough that it got all over various tables and objects in the room before we noticed it. She is a special needs child and is very active. The cut on her finger did not look deep or serious but bled for about 3 hours.  Since she left for the day, we are not sure how long it bled.  Her mother was contacted and told us that she bleeds a lot when hurt.  This is very worrisome to me.  Are there any disorders that would cause this?  Thank you again!

Answer
Hi Tanya,

Yes, she MUST be investigated for coagulation disorders. The problem may be congenital (by birth) deficiency of one of the many factors that are needed for the blood to clot. The most common of these is hemophilia: however, it rarely causes problem in girls.

Another class of disorders is deficiency or defective function of platelets in body..as platelets are also essential for initial building up of blood clot.

Sometimes, the defect is secondary to some other problem, like liver disorders (since all the coagulation factors are normally synthesized by liver).


So there is a number of disorders that can cause it: she MUST be worked up for them.


It would be great to hear back from you as and when her diagnosis is confirmed...


Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India

+91-9818356846, +91-11-45535647

www.KumarChildClinic.com

Pediatrics

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Dr. Puneet Kumar

Expertise

I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query requiring specific diagnosis of a particular subject.

Experience

I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 15 years of experience in the field.

Organizations
Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (http://www.kumarchildclinic.com)

Publications
(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. http://www.pediatricsciences.com/issue/view/1050000010 (f) Regular column, “How do I treat” in Pediascene (www.pediascene.com) (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 (http://www.pediascene.com/page.php?cid=6&catid=9&id=132 ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

Education/Credentials
After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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