|update 2014: Petechiae from crying|
|update 2014: petechiae from screaming|
|Note the little freckling of red dots under her eyes and across her cheek bones. [Oct. 2011]|
What exactly is petechiae and how does little Miss Ellie Bellie Bear come to have petechiae on her precious wee little face?
Definition: petechiae appears as small, red/purple/brown, pin-point dots on the skin as a result of bleeding (from capillaries) under the skin's surface. To differentiate between a rash and petechiae, the rash disappears when pressed on while petechiae remains.
|Those tiny, needle-point, red-purple dots are petechiae. This is Ellie's inner arm .|
The How It Happened: screaming like a poor little terrified banshee while being held on her back, sans diaper for a urinary catheterization about 1 month ago. My baby! Mama bear was crying too but not enough to get petechiae.
Why are so many of us in the Down syndrome community freaked out by rashes that could possibly be petechiae?
One word: CANCER or make that two LEUKEMIA and cancer
Children with Down syndrome are at a greater risk for leukemia--as in 20 times higher than the general 46-chromosomed population . Those who carry that extra 21st chromosome are at a greater risk for acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) with most cases of AML developing before the age of 5. It is why our children must have routine CBC (complete blood count) labs drawn at well-child visits.
Sometimes, petechiae is sign of leukemia in our children because it suggests poor clotting. The capillaries burst and leak into the surround skin, thus causing those pin-point dots. Poor clotting can be the result of impaired platelet function (a component of our blood that works in clotting). The nasty abnormal cancer cells start to crowd out the normal blood cells which include platelets.
Decreased platelets = decreased clotting function = bleeding under skin = petechiae
DO NOT PANIC!
Petechiae can be the result of so many things--not just cancer. See Toddler Bear above--screaming popped some of those delicate little capillaries around her eyes. Forceful vomiting can do the same thing.
Other causes of petechiae:
- Forceful coughing
- Screaming (ie Ellie getting cathed)
- Infections such as Mononucleosis, Measles, and enterovirus
- Platelet Disorders
- Vitamin K deficiency (infants)
This is from a tourniquet used in Ellie's most recent blood draw.
This is the result of a little fall at a playground where she bonked the side of her forehead aka temple.
Viruses such as enterovirus (which by the way also causes low, intermittent fevers that also freak out the hypochondriac mama inside of me):
Now, I am the paranoid mama bear who sits quaking in my flip-flops due to Ellie's propensity to sprout petechiae at any given moment. Routine CBCs have been normal. I am slowly starting to calm down and not jump to conclusions every time Ellie Bear gets a patch of petechiae on her face, under hear arms, or on her ear lobes of all places. My daughter is fair-skinned and some of her little capillaries are visible to the naked eye on her cheeks and neck. Our pediatrician and myself believe that Ellie is just going to be a petechiael kind of girl. Will we continue to monitor her blood cells? Absolutely! Will I panic with each episode? No. . . . well, in theory no.
The Mayo Clinic. Petechiae
National Cancer Institute. Childhood Acute Lymphoblastic Leukemia.
Cinicnnati Children's Hospital Heart-Related Syndromes: Down Syndrome (T21)