Causes of pediatric rhinorrhea can be divided into rhinorrhea triggered by local factors and rhinorrhea caused by systemic factors.
Local factors Common local causes in children are: (1) Dry rhinitis It is the most common cause in children, usually due to dry nasal mucosa and increased vascular fragility, which triggers bleeding during defecation, sneezing, and sleep, mostly caused by improper diet, such as not eating vegetables and drinking little water, accounting for more than 90% in clinical practice.
(2) Nasal foreign body or nose digging Children aged 2 to 5 years old like to dig their noses with their hands or will stuff various foreign bodies into the nasal cavity, which also often causes nasal bleeding, the bleeding volume in this case is less, but it is also a very common clinical phenomenon.
(3) nasal trauma is also one of the common causes of children, because children are more active, easier to have accidents than adults, and the nose is a more vulnerable part of the face, once injured will trigger nasal bleeding, and even more serious, bleeding volume. In addition, medical trauma, such as nasal endoscopic surgery, due to the small field of view of children, if improperly operated, easy to cause fractures of the sieve bone or pterygoid bone, triggering bleeding, hematoma and other conditions.
(4) Acute and chronic inflammation of the nose Generally speaking, rhinitis and sinusitis in children are much milder than those in adults, and the duration of the disease is short, and refractory rhinitis is rare, so rhinorrhea caused by rhinitis alone is rare and less severe.
(5) Nasal tumors In childhood, malignant tumors of the nasal cavity and sinuses are rare, but nasal bleeding is often the first symptom. Among benign tumors, nasopharyngeal fibrovascular tumor is the most common cause of nasal bleeding, which is mostly seen in male adolescents around 8-20 years old, with heavy bleeding, repeatedly delayed and eventually requiring surgical removal. Nasal hemangioma can also cause nasal bleeding to varying degrees and often requires surgical treatment.
Systemic factors The systemic factors of nasal bleeding in children are: (1) Hematological diseases are one of the common systemic factors causing nasal bleeding in children. Such as hemophilia, leukemia, thrombocytopenic purpura, aplastic anemia, etc.. Since childhood is a good stage for blood disorders, nasal bleeding is often the first symptom. Therefore, patients with recurrent nasal bleeding should be screened for blood disorders, such as routine blood tests, to avoid missing the diagnosis.
(2) Acute febrile diseases including viral infections of the upper respiratory tract, hemorrhagic fever, measles, etc., mainly due to high fever causing vascular nerve dysfunction and capillary rupture causing bleeding.
(3) Nutritional disorders or vitamin deficiencies Such as vitamin C, K and P deficiency, vitamin C is closely related to vascular permeability; vitamin K is related to prothrombin formation, and deficiency will cause rhinorrhea. In children, long-term partial eating is the main cause of nutritional disorders and micronutrient deficiencies.
(4) Systemic chronic diseases such as hypertension and liver and kidney dysfunction can affect coagulation function, but they are less common in children.
(5) Genetic diseases Most often seen in children, such as hereditary capillary dilation, Osler’s disease, which is an autosomal inherited disease.
The above etiologies can occur individually, or in complex cases there may be multiple factors that must be carefully examined and analyzed and considered thoroughly.