PEDIATRICS Vol. 90 No. 1 July 1992, pp. 33-36
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A Role for Prostacyclin in Bruising Symptomatology

Jon M. Gerrard MD, PhD1, Elena Duta 1, Barbara Nosek-Cenkowska MD1, Sandra Singhroy BSc1, Mary Cheang MMath2, and Nathan L. Kobrinsky MD1

1 From the Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
2 From the Community Health Services, University of Manitoba, Winnipeg, Manitoba, Canada

The relationship between bleeding and bruising and the production of prostacyclin and thromboxane was assessed in children who were to have a tonsillectomy and/or an adenoidectomy. Eicosanoids in the blood oozing from the bleeding time incision were measured and correlated with the reported frequency of bruising and epistaxis. A striking association (P .0003) between prostacyclin production and the frequency of bruising was found; children reporting bleeding at least biweekly had the highest prostacyclin synthesis. Successively lower levels of the prostacyclin metabolite, 6-keto-prostaglandin F1agr, were found in children reporting less frequent bruising. Prostacyclin production in bleeding time blood was also correlated inversely with systolic blood pressure and hemoglobin level, although neither of these variables could explain the association between prostacyclin production and bruising. There was no correlation between thromboxane formation, systolic blood pressure, hemoglobin level, age, or bleeding time and the frequency of bruising. The ratio of thromboxane B2 to 6-keto-prostaglandin F1agr was correlated inversely with the length of the bleeding time (P = .016). It is concluded that vascular prostacyclin production may have a role in bruising symptomatology. It is suggested that prostacyclin formed at the injured vessel surface collects within the first few seconds after injury inside the tissue space at the site of the bruise and, by influencing the formation of the platelet/fibrin plug and/or the leakage of blood from the vessels, plays a significant role in modifying the development of bruising.

Key Words: bruising • bleeding • thromboxane • prostacyclin • blood pressure • hemoglobin

Submitted on March 18, 1991
Accepted on December 9, 1991




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