Blood disorders in children cover a wide range: common and easily treated problems such as iron deficiency anaemia, inherited haemoglobin conditions such as thalassaemia and sickle cell disease, bleeding disorders such as haemophilia and immune thrombocytopenia, and rarer marrow failure and blood cancers.
They are looked after by paediatric haematologists. Many are lifelong conditions managed with regular monitoring, so the centre that follows your child needs to be within reach of home.
Symptoms
- Pallor, tiredness, poor feeding or slower growth
- Easy bruising or tiny red-purple spots on the skin (petechiae)
- Frequent or prolonged nosebleeds, bleeding gums, or bleeding into joints
- Yellow eyes or skin and dark urine
- Repeated or unusually severe infections
- Episodes of severe bone, chest or abdominal pain in sickle cell disease
- A swollen abdomen from an enlarged spleen or liver
- Persistent fever, bone pain or swollen glands
Causes and risk factors
Nutritional iron deficiency is by far the commonest cause, especially in toddlers who drink a lot of cow's milk and in adolescent girls. Inherited conditions include thalassaemia and sickle cell disease, which are frequent around the Mediterranean, Middle East, Africa and South Asia, as well as G6PD deficiency, hereditary spherocytosis, haemophilia and von Willebrand disease. Immune thrombocytopenia often follows a viral infection. Aplastic anaemia, Fanconi anaemia and leukaemia are rare but serious causes of low counts.
How it is diagnosed
- Full blood count and blood film: The starting point; the appearance of cells under the microscope often suggests the diagnosis.
- Iron studies, B12 and folate: Identify nutritional causes.
- Haemoglobin electrophoresis or HPLC: Diagnoses thalassaemia and sickle cell disorders; also used for parental carrier testing.
- Clotting screen and factor assays: Measure factor VIII, factor IX and von Willebrand factor in a child who bleeds easily.
- Genetic testing: Confirms inherited conditions and allows family counselling and prenatal diagnosis.
- Bone marrow examination: Performed under sedation when marrow failure or leukaemia is suspected.
Treatment options
- Iron and dietary change: Oral iron for about 3 months and limiting cow's milk in young children.
- Regular transfusion with iron chelation: The backbone of care for thalassaemia major, every 2 to 4 weeks for life unless a curative option is possible.
- Hydroxyurea and preventive care in sickle cell disease: Reduces painful crises; combined with vaccinations, penicillin prophylaxis in early childhood and stroke screening.
- Factor replacement and non-factor therapy: Regular prophylaxis in haemophilia prevents joint damage. Emicizumab is an under-the-skin alternative for haemophilia A.
- Observation, steroids or immunoglobulin: Most childhood immune thrombocytopenia resolves within months; treatment is for significant bleeding.
- Stem cell transplant: Can cure thalassaemia major, sickle cell disease and marrow failure when a matched donor, ideally a sibling, is available. It carries serious risks and needs months near the transplant centre.
When it is urgent
Take your child to the nearest emergency department for bleeding that will not stop, a head injury in a child with a bleeding disorder, fever of 38.5 degrees or more in a child with sickle cell disease or low white cells, severe pain, breathing difficulty, sudden weakness, or sudden pallor with a rapidly enlarging spleen.
Travelling to Türkiye for treatment
Day to day care of a child's blood disorder belongs with a team close to home, and an unwell child should not be flown for assessment. Travel can be reasonable for a defined purpose: a diagnostic second opinion with genetic testing, or a stem cell transplant from a matched family donor, which means staying about 3 to 6 months with at least one parent. Donor searches, tissue typing of siblings and the full medical file should be reviewed before any commitment.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Will my child grow out of it?
Iron deficiency and most immune thrombocytopenia resolve. Inherited conditions are lifelong, though well controlled children lead full lives.
Should brothers and sisters be tested?
For inherited disorders, yes. It identifies carriers and possible transplant donors.
Is gene therapy available?
Gene therapies for thalassaemia, sickle cell disease and haemophilia are licensed in a few countries, at limited centres. Ask directly whether a centre offers a licensed product or a trial.
Can my child play sport?
Usually, with sensible adjustments. Contact sports need discussion in bleeding disorders and in children with a large spleen.