Cases of epistaxis in which checking for purpura was useful for the diagnosis

Abstract

Patients with blood disease often visit otorhinolaryngologists due to nasal bleeding. In patients with blood disease, nasal bleeding can be difficult to stop and also carry a risk of sudden death. Early diagnoses are this important in cases of nasal bleeding in blood disease patients. Purpura is a well-known physical finding of bleeding tendency, but checking for purpura is not commonly performed by otorhinolaryngologists. We herein report five cases of nasal bleeding in blood disease patients in which checking for purpura was useful for the diagnosis. Case 1. A 71-year-old male with acute myeloid leukemia. Case 2. A 71-year-old male with malignant lymphoma accompanied by idiopathic thrombocytopenic purpura and nasal neurofibroma. He died of bleeding shock and sepsis shortly after admission. Case 3. A 72-year-old male with idiopathic thrombocytopenic purpura. Case 4. A 2-year-and-10-month-old male with idiopathic thrombocytopenic purpura. Case 5. A 2-year-and-9-month-old female with lupus anticoagulant-hypoprothrombinemia syndrome. I recommend checking for purpura when treating patients with nasal bleeding.