Coagulation Disorders in Early Childhood: Pathophysiology, Diagnosis and Clinical Implications: A Narrative Review
DOI:
https://doi.org/10.67224/ioasdjmps.2026.v03i03.001Keywords:
Coagulation disorders, Early childhood, Hemostasis, Bleeding disorders, Pediatric thrombosisAbstract
Coagulation disorders in early childhood represent a critical group of hemostatic abnormalities that can lead to significant bleeding or thrombotic events. These disorders arise from both inherited defects, such as hemophilia and von Willebrand disease, and acquired conditions like vitamin K deficiency and disseminated intravascular coagulation. The unique developmental physiology of the pediatric coagulation system adds complexity to their pathophysiology and clinical presentation, requiring age-specific considerations for accurate diagnosis and management. Diagnosis of coagulation disorders in young children relies on a combination of thorough clinical assessment and targeted laboratory investigations. Screening tests such as prothrombin time and activated partial thromboplastin time must be interpreted within pediatric reference ranges, and confirmatory factor assays and genetic tests are often necessary. Early identification of these disorders is essential to initiate appropriate therapies, prevent complications, and improve quality of life. The clinical implications of coagulation disorders in early childhood are profound, ranging from life-threatening hemorrhages to venous thromboembolism. Management strategies must be tailored to the child’s specific disorder, balancing efficacy and safety in a population with unique physiological needs. This review emphasizes the importance of multidisciplinary care, timely diagnosis, and advances in treatment approaches to optimize outcomes in affected children.
References
1. Moiseiwitsch, N., & Brown, A. C. (2021). Neonatal coagulopathies: a review of established and emerging treatments. Experimental Biology and Medicine, 246(12), 1447-1457. doi: 10.1177/15353702211006046.
2. Davenport, P., & Sola-Visner, M. (2021). Hemostatic challenges in neonates. Frontiers in pediatrics, 9, 627715. doi: 10.3389/fped.2021.627715.
3. Abdulsalam, A. H., Al-Rahal, N. K., & Ghiath, Y. (2021). Inherited Bleeding Disorders in Pediatric Patients; experience of the national referral center in Iraq. Indian Journal of Hematology and Blood Transfusion, 37(1), 96-100. doi: 10.1007/s12288-020-01306-8.
4. McMillan, C. W., Weiss, A. E., & Johnson, A. M. (1972). Acquired coagulation disorders in children. Pediatric Clinics of North America, 19(4), 1029-1045. doi: 10.1016/s0031-3955(16)32780-8.
5. Obeagu, E. I. (2025). Pediatric thrombosis: Risk factors, diagnosis, and prevention strategies. Medicine, 104(29), e43370. doi: 10.1097/MD.0000000000043370.
6. Sarnaik, A., Kamat, D., & Kannikeswaran, N. (2010). Diagnosis and management of bleeding disorder in a child. Clinical pediatrics, 49(5), 422-431. doi: 10.1177/0009922809351090.
7. Gong, F., Zheng, X., Zhao, S., Liu, H., Chen, E., Xie, R., ... & Chen, Y. (2025). Disseminated intravascular coagulation: cause, molecular mechanism, diagnosis, and therapy. MedComm, 6(2), e70058. doi: 10.1002/mco2.70058.
8. Gorio, C., Molinari, A. C., Martini, T., Ferretti, A., Albrici, G., Carracchia, G., ... & Santoro, R. C. (2025). Hemostasis Laboratory Diagnostics in Newborns. Journal of Clinical Medicine, 14(14), 5068. doi: 10.3390/jcm14145068.
9. Khizroeva, J., Makatsariya, A., Vorobev, A., Bitsadze, V., Elalamy, I., Lazarchuk, A., ... & Blbulyan, D. (2023). The hemostatic system in newborns and the risk of neonatal thrombosis. International Journal of Molecular Sciences, 24(18), 13864. doi: 10.3390/ijms241813864.
10. Hoang, T., & Dowdy, R. A. (2024). Review of inherited coagulation disorders. Anesthesia Progress, 71(2), 87-95. doi: 10.2344/anpr-71-2_continuing_edu.
11. Tourbih, H., Harrach, A., Bencharef, H., Dehbi, H., Oukkache, B., & TOURBIH, H. (2025). Molecular Aspects of Rare Coagulation Factor Deficiencies. Cureus, 17(7) e89102. doi: 10.7759/cureus.89102.
12. O’Brien, S. H., & Zia, A. (2022). Hemostatic and thrombotic disorders in the pediatric patient. Blood, The Journal of the American Society of Hematology, 140(6), 533-541.doi: 10.1182/blood.2020006477.
13. Gorio, C., Molinari, A. C., Martini, T., Ferretti, A., Albrici, G., Carracchia, G., ... & Santoro, R. C. (2025). Hemostasis Laboratory Diagnostics in Newborns. Journal of Clinical Medicine, 14(14), 5068. doi: 10.3390/jcm14145068.
14. Neutze, D., & Roque, J. (2016). Clinical evaluation of bleeding and bruising in primary care. American family physician, 93(4), 279-286.
15. Merriman, L., & Greaves, M. (2006). Testing for thrombophilia: an evidence-based approach. Postgraduate medical journal, 82(973), 699-704.doi: 10.1136/pgmj.2006.048090.
16. Kanne, J. P., & Lalani, T. A. (2004). Role of computed tomography and magnetic resonance imaging for deep venous thrombosis and pulmonary embolism. Circulation, 109(12_suppl_1), I-15-21.doi: 10.1161/01.CIR.0000122871.86662.72.
17. Rahaghi, F. N., Minhas, J. K., & Heresi, G. A. (2018). Diagnosis of deep venous thrombosis and pulmonary embolism: new imaging tools and modalities. Clinics in chest medicine, 39(3), 493-504. doi: 10.1016/j.ccm.2018.04.003.
18. Santhosh, V. C., Mahajan, A., Manas, A., Pawar, M., & Gupta, S. (2025). Oral health and quality of life in children with blood coagulation disorders and hemoglobinopathies. A cross-sectional study. Journal of Family Medicine and Primary Care, 14(6), 2497-2501. doi: 10.4103/jfmpc.jfmpc_1911_24.
19. Morfini, M., Coppola, A., Franchini, M., & Di Minno, G. (2013). Clinical use of factor VIII and factor IX concentrates. Blood Transfusion, 11(Suppl 4), s55-63. doi: 10.2450/2013.010s.
20. Lim, M. Y. (2021). How do we optimally utilize factor concentrates in persons with hemophilia?. Hematology, 2021(1), 206-214. doi: 10.1182/hematology.2021000310.
21. Tuohy, E., Litt, E., & Alikhan, R. (2011). Treatment of patients with von Willebrand disease. Journal of blood medicine, 49-57. doi: 10.2147/JBM.S9890.
22. Stephens, K., Miller, J. L., Harkin, M., Neely, S. B., Haws, L., & Johnson, P. N. (2023). Effect of phytonadione on correction of coagulopathy in pediatric patients with septic shock. The Journal of Pediatric Pharmacology and Therapeutics, 28(5), 423-429. doi: 10.5863/1551-6776-28.5.423.
23. Monagle, P., & Newall, F. (2018). Management of thrombosis in children and neonates: practical use of anticoagulants in children. Hematology 2014, the American Society of Hematology Education Program Book, 2018(1), 399-404. doi: 10.1182/asheducation-2018.1.399.
24. Onwuzo, C., Olukorode, J., Sange, W., Tanna, S. J., Osaghae, O. W., Hassan, A., ... & Fayemi, T. (2023). A review of the preventive strategies for venous thromboembolism in hospitalized patients. Cureus, 15(11): e48421. doi: 10.7759/cureus.48421.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Emmanuel Ifeanyi Obeagu (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The IOASD Journal of Medical and Pharmaceutical Sciences publishes all articles under the Creative Commons Attribution–NonCommercial 4.0 International (CC BY-NC 4.0) License. Under this license, readers are free to copy, distribute, share, adapt, and reproduce the published work in any medium or format for non-commercial purposes, provided that appropriate credit is given to the original author(s) and the source.
