Epistaxis Due to Platelet Dysfunction in a Healthy Person During Office Reconstruciton

Abstract

A healthy 63-year-old male developed severe unprovoked recurrent nose bleeding over a 40-day period.\xa0 He had no other symptoms and his past-medical and family histories were non-contributory.\xa0 His physical examination, complete blood counts, and coagulation profile were normal.\xa0 Three weeks into the illness, a platelet function screen was found abnormal.\xa0 Hematology consultation did not find a cause for his thrombasthenia.\xa0 After a short hospitalization for severe epistaxis, recurrent nosebleeds stopped.\xa0 Several months later, the platelet function screen was normal.\xa0 Post-hoc review of history found that the onset and duration of his nose bleeding and platelet dysfunction coincided with office reconstruction, which generated a strong aromatic smell.\xa0 He was physically closer to the reconstruction site than unaffected co-workers.\xa0 There was a temporal relation between the intensity of exposer to office environment and the intensity of bleeding.\xa0 It is probable that the cause of his platelet dysfunction was an inhaled unidentified toxic chemical(s).\xa0 The management of his epistaxis and risk of inhalation of toxins as a cause of platelet dysfunction are discussed.