Otorhinolaryngological manifestations of haematological disorders: a case series of five patients

Abstract

Haematological disorders frequently present with orofacial and ear, nose, and throat (ENT) manifestations, which may serve as the first clinical clue to an underlying condition. Recognizing these signs is essential for timely diagnosis and management. This paper presents a case series of five paediatric patients (aged 4-17 years) who presented with head and neck manifestations of previously undiagnosed or known haematological diseases, including postoperative bleeding, post-traumatic bleeding and spontaneous haemorrhage. Cases included mild haemophilia A diagnosed after adenotonsillectomy (case 1), post traumatic Christmas disease (factor IX deficiency) with extensive neck haematoma (case 2), known haemophilia A with refractory epistaxis requiring embolization (case 3), von Willebrand factor deficiency presenting as spontaneous bilateral epistaxis (case 4), and severe haemophilia A diagnosed after tongue laceration repair (case 5). All cases were successfully managed with factor replacement, fresh frozen plasma, desmopressin, or recombinant von Willebrand factor. Persistent, recurrent or unusual ENT symptoms- particularly when accompanied by unexplained bleeding- should prompt haematological evaluation. A multidisciplinary approach is critical for accurate diagnosis and improved outcomes in this patient population.