Minford A M B, Richards E M
Department of Paediatrics, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK.
Arch Dis Child Educ Pract Ed. 2010 Feb;95(1):2-8. doi: 10.1136/adc.2009.159707.
A mistaken diagnosis of child abuse can occur in a number of medical conditions, many of which can be readily diagnosed by experienced paediatricians. Bleeding disorders offer a greater challenge, especially when court proceedings may demand their exclusion. Some of these disorders are rare but more prevalent in areas which have a high incidence of consanguinity. We advocate two stages of laboratory investigations but the limitations of some of these tests and their inability to exclude a bleeding disorder with absolute certainty should be recognised. However, if personal and family histories are absent and both first-stage and second-stage investigations are normal, it is highly unlikely that a bleeding disorder will be missed.
在许多医疗情况下都可能出现虐待儿童的误诊，其中许多情况经验丰富的儿科医生都能轻易诊断出来。出血性疾病带来的挑战更大，尤其是在法庭程序可能要求排除此类疾病的情况下。其中一些疾病很罕见，但在近亲结婚率高的地区更为普遍。我们主张进行两个阶段的实验室检查，但应认识到其中一些检查的局限性以及它们无法绝对确定地排除出血性疾病。然而，如果没有个人和家族病史，且第一阶段和第二阶段的检查都正常，那么漏诊出血性疾病的可能性极小。
