{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:40:10Z","timestamp":1746384010637,"version":"3.40.4"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Acquired coagulopathy is a rare but challenging diagnosis for pediatric emergency physicians. Although the coagulopathy usually presents with mild skin and mucosal hemorrhages, it also can lead to life-threatening events. Thus, accurate interpretation of hints obtained from a detailed history, physical examination, and laboratory findings is essential for the prompt diagnosis and management. This case demonstrates an uncommon cause of coagulopathy; celiac disease that presented with spontaneous bruises and ecchymosis in an adolescent.<\/jats:p>","DOI":"10.1097\/pec.0000000000001597","type":"journal-article","created":{"date-parts":[[2018,9,26]],"date-time":"2018-09-26T21:49:25Z","timestamp":1537998565000},"page":"e77-e78","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Unexpected Diagnosis in an Adolescent With Bruises and Ecchymosis"],"prefix":"10.1097","volume":"37","author":[{"given":"Anil","family":"Er","sequence":"first","affiliation":[{"name":"Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aykut","family":"\u00c7a\u011flar","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pinar","family":"Kuyum","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology, Dokuz Eylul University School of Medicine, Izmir, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatma","family":"Akg\u00fcl","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emel","family":"Ulusoy","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hale","family":"\u00c7itlenbik","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bet\u00fcl Yandim","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology, Dokuz Eylul University School of Medicine, Izmir, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Durg\u00fcl","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nur","family":"Arslan","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology, Dokuz Eylul University School of Medicine, Izmir, Turkey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"Duman","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2018,9,12]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1136\/adc.2007.135749","article-title":"Management of acquired coagulopathy in acute paediatrics","volume":"96","year":"2011","journal-title":"Arch Dis Child Educ Pract Ed"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.cnc.2017.04.005","article-title":"Coagulopathy in and outside the intensive care unit","volume":"29","year":"2017","journal-title":"Crit Care Nurs Clin North Am"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/MPG.0b013e31821a23d0","article-title":"European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease","volume":"54","year":"2012","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1177\/0009922809351090","article-title":"Diagnosis and management of bleeding disorder in a child","volume":"49","year":"2010","journal-title":"Clin Pediatr (Phila)"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1542\/pir.2015-0062","article-title":"Pediatric coagulation disorders","volume":"37","year":"2016","journal-title":"Pediatr Rev"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1007\/s11606-007-0297-y","article-title":"Coagulopathy due to celiac disease presenting as intramuscular hemorrhage","volume":"22","year":"2007","journal-title":"J Gen Intern Med"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00042737-200402000-00016","article-title":"Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease","volume":"16","year":"2004","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1007\/BF02877775","article-title":"Celiac disease with diffuse cutaneous vitamin K-deficiency bleeding","volume":"24","year":"2007","journal-title":"Adv Ther"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/00042737-200605000-00027","article-title":"Prevalence of prolonged prothrombin time in children with coeliac disease","volume":"18","year":"2006","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s13312-017-1058-6","article-title":"Coagulation abnormalities in children with Celiac disease","volume":"54","year":"2017","journal-title":"Indian Pediatr"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"24a","DOI":"10.1177\/000992287301201014","article-title":"Diarrhea and vomiting with bleeding. An unusual presentation of celiac disease","volume":"12","year":"1973","journal-title":"Clin Pediatr (Phila)"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/1752-1947-5-116","article-title":"Coagulopathy as initial manifestation of concomitant celiac disease and cystic fibrosis: a case report","volume":"5","year":"2011","journal-title":"J Med Case Reports"},{"key":"bib13-20250504","first-page":"e191","article-title":"A coeliac child presenting with bleeding","volume":"102","year":"2013","journal-title":"Acta Paediatr"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1097\/00043426-200307000-00023","article-title":"Celiac disease presenting with intracranial bleed and ecchymoses","volume":"25","year":"2003","journal-title":"J Pediatr Hematol Oncol"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1093\/qjmed\/hci011","article-title":"Bilateral massive adrenal haemorrhage revealing coeliac disease","volume":"98","year":"2005","journal-title":"QJM"},{"key":"bib16-20250504","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1097\/00042737-199807000-00017","article-title":"Coeliac disease presenting with intraperitoneal haemorrhage","volume":"10","year":"1998","journal-title":"Eur J Gastroenterol Hepatol"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001597","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:07:35Z","timestamp":1746382055000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001597"}},"subtitle":["Celiac Disease"],"short-title":[],"issued":{"date-parts":[[2018,9,12]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001597","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"type":"electronic","value":"1535-1815"},{"type":"print","value":"0749-5161"}],"subject":[],"published":{"date-parts":[[2018,9,12]]}}}