Epistaxis causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Epistaxis}}
{{Epistaxis}}
'''Editor in Chief''': [[User:Ludi|Liudvikas Jagminas, M.D., FACEP]] [mailto:LJagminas@mhri.org] Phone: 401-729-2419
{{CMG}}; '''Associate Editor-In-Chief''': [[User: Marcelo Zacarkim|Marcelo R. Zacarkim, M.D.]] [mailto:mzacarkim@wikidoc.org] {{KS}} [[User:Amir Bagheri|Amir Behzad Bagheri, M.D.]] {{Jose}}
== Overview ==
 
==Etiology==
==Overview==
The cause of nosebleeds can generally be divided into two categories, ''[[local]]'' and ''[[:wikt:systemic|systemic]]'' factors.
The [[causes]] of [[epistaxis]] can be divided into [[idiopathic]] and [[non-idiopathic]] ones. There are many [[diseases]] and medications that can cause [[epistaxis]] but it also may be spontaneous. Usually [[epistaxis]] is not dangerous but in some cases it can become [[life threatening]]. [[Trauma]] is the most common [[Causes|cause]] of [[epistaxis]].
=== Local factors ===
 
* Anatomical deformities, such as septal spurs or [[Hereditary hemorrhagic telangiectasia|Osler-Weber-Rendu Syndrome]]
==Causes==
* [[Inhalant|Chemical inhalant]]
===Life Threatening Causes===
* Inflammatory reaction (eg. acute respiratory tract infections, chronic sinusitis, allergic rhinitis and environmental irritants)
 
* [[Foreign body|Foreign bodies]]
*[[Hemophilia]]<ref name="KrulewitzFix2019">{{cite journal|last1=Krulewitz|first1=Neil Alexander|last2=Fix|first2=Megan Leigh|title=Epistaxis|journal=Emergency Medicine Clinics of North America|volume=37|issue=1|year=2019|pages=29–39|issn=07338627|doi=10.1016/j.emc.2018.09.005}}</ref>
* Intranasal tumors ([[Nasopharyngeal carcinoma]] in adult, and [[nasopharyngeal angiofibroma]] in adolescent males)
*[[Congestive heart failure]]
* Nasal prong O<sub>2</sub> which tends to dry the nasal mucosa
*[[ITP]]
* Nasal sprays, particularly prolonged or improper use of nasal steroids
*[[Leukemia]]
* Surgery (such as septoplasty and endoscopic sinus surgery)
 
* [[Physical trauma|Trauma]] (usually a sharp blow to the face)
===Common Causes===
* [[Nose-picking]]
 
* Low relative humidity of air breathed occurring especially during winter seasons.
*Local [[trauma]]
===Systemic factors===
*[[Acute sinusitis]]
* Drugs - [[Aspirin]], [[Fexofenadine]]/[[Allegra]]/[[Telfast]], [[warfarin]], [[ibuprofen]], [[clopidogrel]], [[isotretinoin]], desmopressin and others
*[[Allergic rhinitis]]
* [[Alcohol intoxication|Alcohol]] (due to [[vasodilation]])
*[[Anticoagulation]]
* [[Allergies]]
*[[Aspirin]]
* [[Dyscrasia|Blood dyscrasias]]
*[[Rhinitis|Chronic rhinitis]]
* [[Heart failure]] (due to an increase in [[blood pressure#Venous pressure|venous pressure]])
*[[Chronic sinusitis]]
* [[Hematological malignancy]]
*[[Barotrauma]]
* [[Hypertension]]
*[[Cocaine]]
* [[Infectious diseases]]
*[[Common cold]]
* [[Malnutrition]] (especially [[anemia]])
*[[Foreign bodies]]
* [[Narcotics]]
*[[Nose-picking]]
* Vascular disorders
 
* [[Nose-picking]] (especially in children)
===Less Common Causes===
* Muscle tightness as caused by [[scoliosis]] (the tightened muscles cause blood vessels to become constricted, resulting in nosebleeds from the same side as the tightened muscles).
*[[Neoplasia]]
**Sinonasal [[squamous cell carcinoma]]
**[[Papillomas]]
**Juvenile nasopharyngeal [[angiofibroma]]
**Esthesioneuroblastoma
**[[Paraganglioma]]
*[[Vascular malformations]]
**Capillary [[hemangioma]]
**Hereditary hemorrhagic [[telangiectasia]] ([[Osler-Weber-Rendu syndrome]])
*[[Intracranial aneurysms]]<ref name="pmiddoi:10.1016/j.otc.2008.01.003">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=doi:10.1016/j.otc.2008.01.003 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref>
 
There is not enough evidence that [[hypertension]] is a [[risk factor]] for [[epistaxis]].The role of lowering [[blood pressure]] to control and prevent [[epistaxis]] remains controversial.
 
In the table below different causes of epistaxis are classified based on organ system.
 
===Causes by Organ System===
{| style="width: 80%; height: 100px; text-align: justify; text-justify: distribute;" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" |[[Aneurysm|Aneurysm of the carotid artery]], [[atherosclerosis]],  [[Vascular disease|blood vessel disorders]], [[cardiopulmonary resuscitation]], [[coarctation of the aorta]], [[congestive heart failure]], [[hypertension]],  [[malignant hypertension]], [[rheumatic fever]], [[secondary hypertension]], [[superior vena cava syndrome]], [[vascular disorders]]
|-
|- bgcolor="LightSteelBlue"
|'''Chemical / poisoning'''
| bgcolor="Beige" |[[Intoxicative inhalant|Aerosol abuse]], [[ammonia]], [[angiofibroma]], [[biphenyl]], [[rodenticide|borates rodenticide poisoning]], [[rodenticide|brodifacoum rodenticide poisoning]], [[rodenticide|bromadiolone rodenticide poisoning]], [[rodenticide|brown snake rodenticide poisoning]], [[calcium sulfate]], [[Irritation|chemical irritants]], [[rodenticide|chlorophacinone rodenticide poisoning]], [[rodenticide|chromates rodenticide poisoning]], [[rodenticide|coumachlor rodenticide poisoning]], [[coumafuryl rodenticide poisoning]], [[coumatetralyl rodenticide poisoning]], [[difenacoum rodenticide poisoning]], [[difethialone rodenticide poisoning]], [[diphacinone rodenticide poisoning]], [[formaldehyde]], [[indandione rodenticide poisoning]], [[inhalant abuse]], [[irritants|inhaled irritants]], [[matikus rodenticide poisoning]], [[metaldehyde]], [[mouser rodenticide poisoning]], [[mucormycosis]], [[Phosphorous acid|phosphorous]],  [[rodenticide|pindone rodenticide poisoning]], [[rodenticide|ratak plus rodenticide poisoning]], [[rodenticide|rodend rodenticide poisoning]], [[rodenticides]], [[solvent abuse]], [[sulphuric acid]], [[rodenticide|talon rodenticide poisoning]], [[tetrachloroethylene]], [[tetryl]], [[vanadium]], [[rodenticide|volak rodenticide poisoning]], [[rodenticide|volid rodenticide poisoning]], [[tobacco smoke]]
|-
|- bgcolor="LightSteelBlue"
|'''Dental'''
| bgcolor="Beige" |[[Dental extraction]]
|-
|- bgcolor="LightSteelBlue"
|'''Dermatologic'''
| bgcolor="Beige" |[[Cicatricial pemphigoid|Benign mucosal pemphigoid]], [[defibrination syndrome]], [[leprosy]], [[Skin and soft-tissue infections|localized skin infection]], [[melanoma]], [[mucormycosis]],  [[excoriation|nasal excoriation]], [[Osler-Weber-Rendu Disease|Osler-weber-rendu disease]], [[purpura]], [[pyogenic granuloma|septal granulomas]], [[furuncles|staphylococcal furuncles]], [[systemic lupus erythematosus]], [[Thrombocytopenic purpura|thrombocyopenic purpura]]
|-
|- bgcolor="LightSteelBlue"
|'''Drug Side Effect'''
| bgcolor="Beige" |[[Allegra]], [[anticoagulants]], [[antiplatelet drug]], [[aspirin]], [[bicalutamide]], [[budesonide]], [[butorphanol]], [[cefpodoxime]], [[ciclesonide]],[[clemastine|clemastine fumarate]], [[clopidogrel]], [[caspofungin acetate]], [[Clove|clove (herbal agent)]], [[desmopressin]], [[diquat|diquat dibromide]], [[febuxostat]], [[fexofenadine]], [[flurbiprofen]], [[Fluticasone Nasal Spray|fluticasone nasal spray]], [[heroin]], [[histrelin]], [[Ibuprofen]], [[corticosteroids]], [[ipratropium bromide]], [[isotretinoin]][[leflunomide]], [[lenvatinib]], [[loratadine]], [[meropenem]], [[metipranolol]], [[miltefosine]], [[narcotics]], [[Corticosteroid |nasal steroids]], [[olopatadine]], [[oxcarbazepine]], [[palbociclib]], [[Pennyroyal|pennyroyal oil (herbal agent)]], [[pramipexole]], [[prasugrel]], [[ramucirumab]], [[retapamulin]], [[rifaximin]], [[riociguat]],[[romiplostim]], [[sertraline]], [[sulindac]], [[telfast]], [[tiagabine]], [[thalidomide]], [[tobramycin]], [[topiramate]], [[triamcinolone acetonide]], [[trimethadione]], [[valproic acid]], [[warfarin]]
|-
|- bgcolor="LightSteelBlue"
|'''Ear Nose Throat'''
| bgcolor="Beige" |Abnormal nasal anatomy , [[acute sinusitis]],  [[allergic rhinitis]],  [[Nasal polyp|antrochoanal polyps]],  [[Functional Endoscopic Sinus Surgery|antrostomy]],  [[barotrauma]],  [[Nasopharyngeal angiofibroma|benign nose tumors]],  [[broken nose]],  [[Mucous membrane of nose|chronic irritation of the nasal mucosa]], [[rhinitis|chronic rhinitis]] ,  [[chronic sinusitis]] [[common cold]],  [[deviated septum]],  [[Mucous membrane of nose|dry nasal mucosa]], [[epstein's syndrome]],  [[esthesioneuroblastoma]],  [[Nasal polyp|ethmoidal polyps]], [[hereditary haemorrhagic telangiectasia]], increased nasal venous pressure, [[Rhabdomyosarcoma|intranasal rhabdomyosarcoma]],  [[inverted papilloma]], [[juvenile nasopharyngeal angiofibroma]],  [[Sinonasal undifferentiated carcinoma|maxillary sinus carcinoma]],  [[Maxillofacial trauma|maxillofacial injury]],  [[barotrauma|middle ear barotrauma]],  [[Sinonasal undifferentiated carcinoma|nasal cancer]], [[nasal cannula]],  [[Staphylococcus aureus|nasal colonization with staphylococcus aureus]] ,  [[nasal congestion]],  [[diphtheria|nasal diphtheria]],  [[excoriation|nasal excoriation]],  [[foreign body|nasal foreign body]],  [[nasal fracture]],  [[Infection|nasal infection]], [[nasal congestion|nasal obstruction]],  [[nasal polyp]],  [[Deviated septum|nasal septum deviation]],  [[nasal sprays]],  [[tuberculosis|nasal tuberculosis]],  [[nasopharyngeal angiofibroma]],  [[nasopharyngeal carcinoma]],  [[Ulcer|nasal ulceration]],  [[rhinitis|non-allergic rhinitis]], [[Nose-picking|nose picking]],  [[rhinitis]],  [[rhinoplasty]] [[rhinoscleroma]] [[septal deviation]],  [[Nasal septal perforation|septal perforation]],  [[sinonasal undifferentiated carcinoma]],  [[Sinonasal undifferentiated carcinoma|sinus tumor]],  [[sinusitis]],  [[superior vena cava syndrome]],  [[Kiesselbach's plexus|trauma to littlee's area]],  [[Choanal atresia|unilateral choanal atresia]], [[rhinitis|viral rhinitis]]
|-
|- bgcolor="LightSteelBlue"
|'''Endocrine'''
| bgcolor="Beige" |[[Acthar]], [[cystic fibrosis]], [[corticotropin]]
|-
|- bgcolor="LightSteelBlue"
|'''Environmental'''
| bgcolor="Beige" |Cold air, dry air, [[Irritation|environmental irritants]], [[humidity]]
|-
|- bgcolor="LightSteelBlue"
|'''Gastroenterologic'''
| bgcolor="Beige" |[[Cirrhosis]], [[hepatitis]], [[mucormycosis]], [[progressive familial intrahepatic cholestasis]], [[Banti's syndrome]],  [[Zygomycosis|rhinocerebral mucormycosis]], [[zygomycosis|rhinocerebral zygomycosis]], [[Von Gierke Disease]], [[Zygomycosis]]
|-
|- bgcolor="LightSteelBlue"
|'''Genetic'''
| bgcolor="Beige" |[[P2Y12|ADP platelet receptor P2Y12 deficiency]], [[autoimmune lymphoproliferative syndrome]], [[Banti's syndrome]], [[christmas disease]], [[coarctation of the aorta]], [[congenital afibrinogenemia]], [[congenital hypoplastic anemia]], [[congenital syphilis]], [[Factor I Deficiency|Congential fibrinogen deficiency]], [[connective tissue disease]], [[cystic fibrosis]], [[Grey platelet syndrome|familial platelet syndrome]], [[Fanconi's anemia]], [[Hemoglobin Lepore syndrome]], [[ hemophilia]], [[Hermansky-Pudlak syndrome]], [[Coagulopathy|inherited  coagulation disorders]], [[leukocyte adhesion deficiency]], [[May-Hegglin anomaly]], [[Osler-Weber-Rendu Disease]], [[Factor V|Owren parahemophilia]], [[progressive familial intrahepatic cholestasis]], [[prothrombin deficiency]], [[sickle cell anemia]], [[Von Gierke disease]], [[Von Willebrand disease]],  [[Congenital dyserythropoietic anemia|X-linked dyserythropoietic anemia and thrombocytopenia]]
|-
|- bgcolor="LightSteelBlue"
|'''Hematologic'''
| bgcolor="Beige" |[[Coagulopathy|Acquired coagulation disorders]], [[Factor XIII deficiency|acquired factor XIII deficiency]], [[acute erythroleukemia]], [[acute leukemia]],  [[acute lymphocytic leukemia]], [[acute promyelocytic leukemia]], [[anemia]], [[aplastic anemia]], [[autoimmune lymphoproliferative syndrome]], [[Idiopathic thrombocytopenic purpura|autoimmune thrombocytopenia]], [[Bernard-Soulier syndrome]], [[Bing-Neel syndrome]], [[bleeding diathesis]], [[bleeding disorders]], [[bleeding tendency]],  [[Dyscrasia|blood dyscrasias]], [[christmas disease]], [[chronic leukemia]], [[coagulation disorders]], [[congenital afibrinogenemia]], [[congenital hypoplastic anemia]],  [[Factor I Deficiency|congential fibrinogen deficiency]], [[defibrination syndrome]], [[Epstein's syndrome]], [[Factor V|factor V deficiency]], [[factor VII|factor VII deficiency]], [[factor X|factor X deficiency]], [[dyscrasia|familial blood dyscrasias]], [[Grey platelet syndrome|familial platelet syndrome]], [[Fanconi's anemia]],  [[hematological malignancy]], [[Hemoglobin Lepore syndrome]], [[hemoglobin SC]], [[ hemophilia]], [[Hermansky-Pudlak syndrome]], [[idiopathic thrombocytopenic purpura]],  [[coagulopathy|Inability of the blood to clot]], [[leukaemia]], [[lymphomatoid granulomatosis]], [[May-Hegglin anomaly]], [[myelodysplastic syndromes]], [[myeloproliferative diseases]], [[Factor V|Owren parahemophilia]], [[pancytopenia]], [[Blood type|people with blood group O]], [[Giant platelet disorder|platelet disorders]], [[polycythemia vera]],  [[purpura]], [[sickle cell anemia]], [[Factor X|stuart factor deficiency]], [[superior vena cava syndrome]], [[thrombasthenia]], [[thrombocytopenic purpura]],  [[thrombocytopathy]], [[thrombocytopenia]], [[Von Willebrand disease]], [[Waldenstrom macroglobulinemia]], [[Congenital dyserythropoietic anemia|X-linked dyserythropoietic anemia and thrombocytopenia]]
|-
|- bgcolor="LightSteelBlue"
|'''Iatrogenic'''
| bgcolor="Beige" |[[Adenoidectomy]], [[functional Endoscopic Sinus Surgery|antrostomy]], [[dental extraction]], [[Functional Endoscopic Sinus Surgery|endoscopic sinus procedures]], [[oral and maxillofacial surgery|facial surgery]], [[nasal cannula]], [[surgery|nasal surgery]], [[nasogastric intubation|nasogastric tube placement]], [[tracheal intubation|nasotracheal intubation]], [[eye surgery|Orbital decompression]], [[bleeding|postoperative]], [[rhinoplasty]], [[septoplasty]], [[sinus surgery]], [[turbinectomy]]
|-
|- bgcolor="LightSteelBlue"
|'''Infectious Disease'''
| bgcolor="Beige" |[[Argentinean hemorrhagic fever]], [[Bolivian hemorrhagic fever]], [[congenital syphilis]], [[dengue hemorrhagic fever]], [[Hantavirosis]], [[hepatitis]],  [[Mediastinitis|idiopathic fibrosing mediastinitis]], [[infectious diseases]], [[Inflammation |inflammatory disorders]], [[leprosy]], [[Skin and soft-tissue infections|localized skin infection]], [[Machupo virus]], [[mucocutaneous leishmaniasis]], [[mucormycosis]], [[Diphtheria|nasal diphtheria]], [[infection|nasal infection]], [[Omsk hemorrhagic fever]],  [[tuberculosis|nasal tuberculosis]], [[pertussis]], [[relapsing fever]], [[respiratory tract infection]], [[Zygomycosis|rhinocerebral mucormycosis]], [[Zygomycosis|rhinocerebral zygomycosis]], [[rheumatic fever]], [[rhinoscleroma]], [[rhinosporidiosis]], [[scleroma]], [[sinusitis]], [[Stachybotrys chartarum]], [[Skin and soft-tissue infections |Soft tissue infection]], [[Furuncles|Staphylococcal furuncles]], [[Streptococcus pyogenes|Streptococcus pyogenes infection]], [[Nasal congestion|systemic infection with nasal congestion]], [[tuberculosis]], [[typhoid fever]], [[rhinitis |viral rhinitis]], [[upper respiratory infections|viral upper respiratory infections]], [[Weil syndrome]], [[whooping cough]], [[zygomycosis]]
|-
|- bgcolor="LightSteelBlue"
|'''Musculoskeletal / Ortho'''
| bgcolor="Beige" |No underlying causes
|-
|- bgcolor="LightSteelBlue"
|'''Neurologic'''
| bgcolor="Beige" |[[Dysautonomia|Acute cholinergic dysautonomia]], [[Bing-Neel syndrome]], [[head injury]], [[Osler-Weber-Rendu syndrome]]
|-
|- bgcolor="LightSteelBlue"
|'''Nutritional / Metabolic'''
| bgcolor="Beige" |[[P2Y12|ADP platelet receptor p2y12 deficiency]], [[Clove|clove (herbal agent)]], [[cystic fibrosis]], [[dieting|excessive dieting]], [[ginseng]], [[glycogen storage disease]], [[malnutrition]], [[weight loss|rapid weight loss]], [[vitamin C deficiency]], [[vitamin K deficiency]], [[Von Gierke disease]]
|-
|- bgcolor="LightSteelBlue"
|'''Obstetric/Gynecologic'''
| bgcolor="Beige" |[[Menopause]], [[pregnancy]]
|-
|- bgcolor="LightSteelBlue"
|'''Oncologic'''
| bgcolor="Beige" |[[Acute erythroleukemia]], [[acute leukemia]], [[acute lymphocytic leukemia]], [[acute promyelocytic leukemia]], [[adenoid cystic carcinoma]], [[angiofibroma]], [[chronic leukemia]], [[esthesioneuroblastoma]], [[hemangioma]], [[hematological malignancy]], [[Rhabdomyosarcoma|Intranasal rhabdomyosarcoma]], [[inverted papilloma]], [[juvenile nasopharyngeal angiofibroma]], [[leukaemia]], [[Sinonasal undifferentiated carcinoma|maxillary sinus carcinoma]], [[melanoma]], [[myelodysplastic syndromes]], [[myeloproliferative diseases]], [[Sinonasal undifferentiated carcinoma|nasal cancer]], [[Extranodal NK-T-cell lymphoma|nasal type natural killer/t-cell lymphoma]], [[nasopharyngeal angiofibroma]], [[nasopharyngeal carcinoma|nasopharyngeal cancers]], [[nasopharyngeal carcinoma]], [[neoplasm]], [[Calcifying epithelial odontogenic tumor|pindborg tumor]], [[polycythemia vera]], [[rhabdomyosarcoma]], [[Sinonasal undifferentiated carcinoma]], [[squamous cell carcinoma]], [[Waldenstrom macroglobulinemia]]
|-
|- bgcolor="LightSteelBlue"
|'''Opthalmologic'''
| bgcolor="Beige" |[[eye surgery|Orbital decompression]]
|-
|- bgcolor="LightSteelBlue"
|'''Overdose / Toxicity'''
| bgcolor="Beige" |[[alcohol|Alcohol abuse]], [[Nasal spray|chronic usage of nasal sprays]], [[vitamin A|chronic vitamin A toxicity]], [[cocaine]], [[heroin]], [[narcotics]]
|-
|- bgcolor="LightSteelBlue"
|'''Psychiatric'''
| bgcolor="Beige" |[[Intoxicative inhalant|Aerosol abuse]], [[alcohol abuse]], [[child abuse]], [[inhalant abuse]], [[solvent abuse]], [[Inhalant|volatile inhalants]]
|-
|- bgcolor="LightSteelBlue"
|'''Pulmonary'''
| bgcolor="Beige" |[[Asphyxiation]], [[barotrauma]], [[common cold]], [[cystic fibrosis]], [[mediastinitis|idiopathic fibrosing mediastinitis]], [[pertussis]], [[respiratory tract infection]], [[sarcoidosis]], [[Wegener's granulomatosis]], [[Whooping cough]]
|-
|- bgcolor="LightSteelBlue"
|'''Renal / Electrolyte'''
| bgcolor="Beige" |[[Chronic kidney disease]], [[Epstein's syndrome]], [[renal artery stenosis]], [[renal dialysis]], [[renal disease]], [[systemic lupus erythematosus]],  [[Wegener's granulomatosis]]
|-
|- bgcolor="LightSteelBlue"
|'''Rheum / Immune / Allergy'''
| bgcolor="Beige" |[[Allergic rhinitis]], [[allergies]], [[autoimmune lymphoproliferative syndrome]], [[Idiopathic thrombocytopenic purpura|autoimmune thrombocytopenia|autoimmune thrombocytopenia]], [[Cicatricial pemphigoid|benign mucosal pemphigoid]], [[immune thrombocytopenic purpura]], [[leukocyte adhesion deficiency]], [[polychondritis]], [[rheumatic fever]], [[rhinitis]], [[sarcoidosis]], [[systemic lupus erythematosus]], [[Wegener's granulomatosis]]
|-
|- bgcolor="LightSteelBlue"
|'''Sexual'''
| bgcolor="Beige" |No underlying causes
|-
|- bgcolor="LightSteelBlue"
|'''Trauma'''
| bgcolor="Beige" |[[Barotrauma]], [[blunt trauma]], [[broken nose]], [[facial trauma]], [[head injury]], [[Maxillofacial trauma|maxillofacial injury]], [[nasal fracture]],  [[pseudoaneurysm|post-traumatic pseudoaneurysm]], [[Skull fracture]], [[basilar skull fracture|sphenoidal fracture]], [[Kiesselbach's plexus|trauma to littlee's area]]
|-
|- bgcolor="LightSteelBlue"
|'''Urologic'''
| bgcolor="Beige" |[[Inverted papilloma]]
|-
|- bgcolor="LightSteelBlue"
|'''Miscellaneous'''
| bgcolor="Beige" |[[Foreign bodies]], [[Pennyroyal|pennyroyal oil]]
|-
|}
 
===Causes in Alphabetical Order===
{{columns-list|
*Abnormal nasal anatomy
*[[Coagulopathy|Acquired coagulation disorders]]
*[[Factor XIII deficiency|Acquired factor XIII deficiency]]
*[[Acthar]]
*[[Dysautonomia|Acute cholinergic dysautonomia]]
*[[Acute erythroleukemia]]
*[[Acute leukemia]]
*[[Acute lymphocytic leukemia]]
*[[Acute promyelocytic leukemia]]
*[[Respiratory tract infection|Acute respiratory tract infections]]
*[[Acute sinusitis]]
*[[Adenoid cystic carcinoma]]
*[[Adenoidectomy]]
*[[P2Y12|ADP platelet receptor p2y12 deficiency]]
*[[Inhalant|Aerosol abuse]]
*[[Alcohol abuse]]
*[[Allegra]]
*[[Allergic rhinitis]]
*[[Allergies]]
*[[Ammonia]]
*[[Anemia]]
*[[Aneurysm |Aneurysm of the carotid artery]]
*[[Angiofibroma]]
*[[Anticoagulant]]
*[[Antiplatelet drug|Antiplatelet medication]]
*[[Nasal polyp|Antrochoanal polyps]]
*[[Functional Endoscopic Sinus Surgery|Antrostomy]]
*[[Aplastic anemia]]
*[[Argentinean hemorrhagic fever]]
*[[Asphyxiation]]
*[[Aspirin]]
*[[Atherosclerosis]]
*[[Autoimmune lymphoproliferative syndrome]]
*[[Idiopathic thrombocytopenic purpura|Autoimmune thrombocytopenia]]
*[[Upper respiratory tract infection|Bacterial upper respiratory infections]]
*[[Banti's syndrome]]
*[[Barotrauma]]
*[[Cicatricial pemphigoid|Benign mucosal pemphigoid]]
*[[Nasopharyngeal angiofibroma|Benign nose tumors]]
*[[Bernard-Soulier syndrome]]
*[[Bing-Neel syndrome]]
*[[Biphenyl]]
*[[Bleeding diathesis]]
*[[Bleeding disorders]]
*[[Dyscrasia|Blood dyscrasias]]
*[[Vascular disease|Blood vessel disorders]]
*[[Blunt trauma]]
*[[Bolivian hemorrhagic fever]]
*[[Borate|Borates rodenticide poisoning]]
*[[Brodifacoum|Brodifacoum rodenticide poisoning]]
*[[Broken nose]]
*[[Bromadiolone|Bromadiolone rodenticide poisoning]]
*[[Rodenticide|Brown snake rodenticide poisoning]]
*[[Butorphanol]]
*[[Calcium sulfate]]
*[[Cardiopulmonary resuscitation]]
*[[Irritation|Chemical irritants]]
*[[Child abuse]]
*[[Chlorophacinone rodenticide poisoning]]
*[[Progressive familial intrahepatic cholestasis|Cholestasis, progressive familial intrahepatic]]
*[[Hemophilia B|Christmas disease]]
*[[Rodenticide|Chromates rodenticide poisoning]]
*[[Excoriation|Chronic excoriation]]
*[[Irritation|Chronic irritation of the nasal mucosa]]
*[[Chronic kidney disease]]
*[[Chronic leukemia]]
*[[Rhinitis|Chronic rhinitis ]]
*[[Chronic sinusitis]]
*[[Nasal spray|Chronic usage of nasal sprays]]
*[[Vitamin A|Chronic vitamin A toxicity]]
*[[Cirrhosis]]
*[[Clemastine|Clemastine fumarate]]
*[[Clopidogrel]]
*[[Clove|Clove (herbal agent)]]
*[[Coagulation disorders]]
*[[Coagulopathy]]
*[[Coarctation of the aorta]]
*[[Cocaine]]
*Cold air
*[[Common cold]]
*[[Congenital afibrinogenemia]]
*[[Congenital hypoplastic anemia]]
*[[Congenital syphilis]]
*[[Factor I Deficiency|Congential fibrinogen deficiency]]
*[[Congestive heart failure]]
*[[Connective tissue disease]]
*[[Corticosteroids]]
*[[Corticotropin]]
*[[Coumachlor rodenticide poisoning]]
*[[Coumafuryl rodenticide poisoning]]
*[[Coumatetralyl rodenticide poisoning]]
*[[Cystic fibrosis]]
*[[Defibrination syndrome]]
*[[Dengue hemorrhagic fever]]
*[[Dental extraction]]
*[[Desmopressin]]
*[[Deviated septum]]
*[[Dialysis]]
*[[Difenacoum rodenticide poisoning]]
*[[Difethialone rodenticide poisoning]]
*[[Diphacinone rodenticide poisoning]]
*[[Diquat|Diquat dibromide]]
*Dry air
*[[Functional Endoscopic Sinus Surgery|Endoscopic sinus procedures]]
*[[Irritation|Environmental irritants]]
*[[Epstein's syndrome]]
*[[Essential hypertension]]
*[[Essential thrombocythemia]]
*[[Esthesioneuroblastoma]]
*[[Nasal polyp|Ethmoidal polyps]]
*[[Dieting|Excessive dieting]]
*[[Facial trauma]]
*[[Oral and maxillofacial surgery|Facial surgery]]
*[[Factor V|Factor V deficiency]]
*[[Factor VII|Factor VII deficiency]]
*[[Factor X|Factor X deficiency]]
*[[Dyscrasia|Familial blood dyscrasias]]
*[[Grey platelet syndrome|Familial platelet syndrome ]]
*[[Fanconi's anemia]]
*[[Fexofenadine]]
*[[Flurbiprofen]]
*[[Fluticasone Nasal Spray (patient information)|Fluticasone]]
*[[Foreign bodies]]
*[[Formaldehyde]]
*[[Functional Endoscopic Sinus Surgery|Functional endoscopic sinus surgery]]
*[[Ginseng]]
*[[Glycogen storage disease]]
*[[Granulomatosis]]
*[[Wegener's granulomatosis|Granulomatosis with polyangiitis]]
*[[Hantavirosis ]]
*[[Head injury]]
*[[Hemophilia]]
*[[Heart failure]]
*[[Hemangioma]]
*[[Hematological malignancy]]
*[[Hemoglobin Lepore syndrome]]
*[[Hemoglobin SC]]
*[[Hepatitis]]
*[[Hereditary haemorrhagic telangiectasia]]
*[[Hermansky-Pudlak syndrome]]
*[[Heroin]]
*[[Histrelin]]
*[[Humidity]]
*[[Hypertension]]
*[[Ibuprofen]]
*[[Mediastinitis|Idiopathic fibrosing mediastinitis]]
*[[Idiopathic thrombocytopenic purpura]]
*[[Coagulopathy|Inability of the blood to clot]]
*[[Increased nasal venous pressure]]
*[[Indandione rodenticide poisoning]]
*[[Infection]]
*[[Inhalant abuse]]
*[[Corticosteroids|Inhaled corticosteroids]]
*[[Intoxicative inhalant|Inhaled irritants]]
*[[Coagulopathy|Inherited  coagulation disorders]]
*[[Rhabdomyosarcoma|Intranasal rhabdomyosarcoma]]
*[[Inverted papilloma]]
*[[Isotretinoin]]
*[[Juvenile nasopharyngeal angiofibroma]]
*[[Lenvatinib]]
*[[Leprosy]]
*[[Leukemia]]
*[[Leukocyte adhesion deficiency]]
*[[Skin and soft-tissue infections|Localized skin infection]]
*[[Loratadine]]
*[[Lymphomatoid granulomatosis]]
*[[Machupo virus]]
*[[Malignant hypertension]]
*[[Malnutrition]]
*[[Matikus rodenticide poisoning]]
*[[Sinonasal undifferentiated carcinoma|Maxillary sinus carcinoma]]
*[[Maxillofacial trauma|Maxillofacial injury]]
*[[May Hegglin anomaly]]
*[[Medications]]
*[[Melanoma]]
*[[Menopause]]
*[[Metaldehyde]]
*[[Barotrauma pathophysiology|Middle ear barotrauma]]
*[[Mouser rodenticide poisoning]]
*[[Mucocutaneous leishmaniasis]]
*[[Mucormycosis]]
*[[Irritation|Mucosal irritation of the nasal mucosa ]]
*[[Myelodysplastic syndromes]]
*[[Myeloproliferative diseases]]
*[[Narcotics]]
*[[Sinonasal undifferentiated carcinoma|Nasal cancer]]
*[[Nasal cannula]]
*[[staphylococcus aureus|Nasal colonization with staphylococcus aureus]]
*[[Nasal congestion]]
*[[Diphtheria|Nasal diphtheria]]
*[[Excoriation|Nasal excoriation]]
*[[Foreign body|Nasal foreign body]]
*[[Nasal fracture]]
*[[Infection|Nasal infection]]
*[[Nasal Congestion|Nasal obstruction]]
*[[Nasal polyp]]
*[[Deviated septum|Nasal septum deviation]]
*[[Nasal sprays]]
*[[Corticosteroid|Nasal steroids]]
*[[Surgery|Nasal surgery]]
*[[Physical trauma|Nasal trauma]]
*[[Tuberculosis|Nasal tuberculosis]]
*[[Extranodal NK-T-cell lymphoma|Nasal type natural killer/t-cell lymphoma]]
*[[Ulcer|Nasal ulceration]]
*[[Nasogastric intubation|Nasogastric tube placement]]
*[[Nasopharyngeal angiofibroma]]
*[[Nasopharyngeal carcinoma|Nasopharyngeal cancers]]
*[[Tracheal intubation|Nasotracheal intubation]]
*[[Neoplasm]]
*[[Rhinitis|Non-allergic rhinitis]]
*[[Nose-picking]]
*[[Omsk hemorrhagic fever]]
*[[Eye surgery |Orbital decompression]]
*[[Osler-Weber-Rendu Disease|Osler-weber-rendu disease]]
*[[Factor V|Owren parahemophilia]]
*[[Palbociclib]]
*[[Pancytopenia]]
*[[Pennyroyal|Pennyroyal oil]]
*[[Blood type|People with blood group O]]
*[[Pertussis]]
*[[PFIC]]
*[[Phosphorous acid|Phosphorous]]
*[[Calcifying epithelial odontogenic tumor|Pindborg tumor]]
*[[Pindone rodenticide poisoning]]
*[[Giant platelet disorder|Platelet disorders]]
*[[Polychondritis]]
*[[Polycythemia vera]]
*[[Pseudoaneurysm|Post-traumatic pseudoaneurysm]]
*[[Pseudoaneurysm|Posttraumatic pseudoaneurysm of internal carotid artery]]
*[[Prasugrel]]
*[[Pregnancy]]
*[[Primary hypertension]]
*[[Progressive familial intrahepatic cholestasis]]
*[[Prothrombin deficiency]]
*[[Purpura]]
*[[Pyogenic granuloma]]
*[[Ramucirumab]]
*[[Rapid weight loss]]
*[[Ratak Plus rodenticide poisoning|Ratak plus rodenticide poisoning]]
*[[Relapsing fever]]
*[[Renal artery stenosis]]
*[[Renal dialysis]]
*[[Renal disease]]
*[[Respiratory tract infection]]
*[[Rhabdomyosarcoma]]
*[[Rheumatic fever]]
*[[Rhinitis]]
*[[Zygomycosis|Rhinocerebral mucormycosis]]
*[[Zygomycosis|Rhinocerebral zygomycosis]]
*[[Rhinoplasty]]
*[[Rhinoscleroma]]
*[[Rhinosporidiosis]]
*[[Riociguat]]
*[[Rodend rodenticide poisoning]]
*[[Rodenticides]]
*[[Sarcoidosis]]
*[[Scleroma]]
*Sclerotic vessels
*[[Pregnancy|Second trimester pregnancy]]
*[[Septal deviation]]
*[[Pyogenic granuloma|Septal granulomas]]
*[[Nasal septum perforation|Septal perforation]]
*[[Septoplasty|Septal surgery]]
*[[Septoplasty]]
*[[Sickle cell anemia]]
*[[Sinonasal undifferentiated carcinoma]]
*[[Sinus surgery]]
*[[Sinonasal undifferentiated carcinoma|Sinus tumor]]
*[[Sinusitis]]
*[[Skull fracture]]
*[[Skin and soft-tissue infections |Soft tissue infection]]
*[[Solvent abuse]]
*[[Basilar skull fracture|Sphenoidal fracture]]
*[[Squamous cell carcinoma]]
*[[Stachybotrys chartarum]]
*[[Furuncles|Staphylococcal furuncles]]
*[[Streptococcus pyogenes|Streptococcus pyogenes infection]]
*[[Factor X|Stuart factor deficiency]]
*[[Sulphuric acid]]
*[[Superior vena cava syndrome]]
*[[Systemic infection|Systemic infection with nasal congestion]]
*[[Systemic lupus erythematosus]]
*[[Talon rodenticide poisoning]]
*[[Telfast]]
*[[Tetrachloroethylene]]
*[[Tetryl]]
*[[Thrombasthenia]]
*[[Thrombocytopenic purpura]]
*[[Thrombocytopathy]]
*[[Thrombocytopenia]]
*[[Tiagabine]]
*[[Tobacco smoking]]
*[[Trauma]]
*[[Kiesselbach's plexus|Trauma to Little's area]]
*[[Corticosteroid|Nasal corticosteroids]]
*[[Tuberculosis]]
*[[Turbinectomy]]
*[[Typhoid fever]]
*[[Choanal atresia|Unilateral choanal atresia]]
*[[Upper respiratory infection]]
*[[valproic acid]]
*[[Vanadium]]
*[[Vascular disorders]]
*[[Vascular malformation]]
*[[Rhinitis|Viral rhinitis]]
*[[Acute viral nasopharyngitis (common cold)|Viral  upper respiratory infections]]
*[[Vitamin C|Vitamin C deficiency]]
*[[Vitamin K|Vitamin K deficiency]]
*[[Volak rodenticide poisoning]]
*[[Inhalant|Volatile inhalants]]
*[[Volid rodenticide poisoning]]
*[[Von Gierke Disease]]
*[[Von Willebrand disease]]
*[[Waldenstrom macroglobulinemia]]
*[[Warfarin]]
*[[Wegener's granulomatosis]]
*[[Weil syndrome]]
*[[Whooping cough]]
*[[Congenital dyserythropoietic anemia|X-linked dyserythropoietic anemia and thrombocytopenia]]
*[[Zygomycosis]]
 
}}
 
==References==
==References==
{{Reflist|2}}
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Latest revision as of 20:32, 29 January 2021

Epistaxis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Marcelo R. Zacarkim, M.D. [2] Kiran Singh, M.D. [3] Amir Behzad Bagheri, M.D. José Eduardo Riceto Loyola Junior, M.D.[4]

Overview

The causes of epistaxis can be divided into idiopathic and non-idiopathic ones. There are many diseases and medications that can cause epistaxis but it also may be spontaneous. Usually epistaxis is not dangerous but in some cases it can become life threatening. Trauma is the most common cause of epistaxis.

Causes

Life Threatening Causes

Common Causes

Less Common Causes

There is not enough evidence that hypertension is a risk factor for epistaxis.The role of lowering blood pressure to control and prevent epistaxis remains controversial.

In the table below different causes of epistaxis are classified based on organ system.

Causes by Organ System

Cardiovascular Aneurysm of the carotid artery, atherosclerosis, blood vessel disorders, cardiopulmonary resuscitation, coarctation of the aorta, congestive heart failure, hypertension, malignant hypertension, rheumatic fever, secondary hypertension, superior vena cava syndrome, vascular disorders
Chemical / poisoning Aerosol abuse, ammonia, angiofibroma, biphenyl, borates rodenticide poisoning, brodifacoum rodenticide poisoning, bromadiolone rodenticide poisoning, brown snake rodenticide poisoning, calcium sulfate, chemical irritants, chlorophacinone rodenticide poisoning, chromates rodenticide poisoning, coumachlor rodenticide poisoning, coumafuryl rodenticide poisoning, coumatetralyl rodenticide poisoning, difenacoum rodenticide poisoning, difethialone rodenticide poisoning, diphacinone rodenticide poisoning, formaldehyde, indandione rodenticide poisoning, inhalant abuse, inhaled irritants, matikus rodenticide poisoning, metaldehyde, mouser rodenticide poisoning, mucormycosis, phosphorous, pindone rodenticide poisoning, ratak plus rodenticide poisoning, rodend rodenticide poisoning, rodenticides, solvent abuse, sulphuric acid, talon rodenticide poisoning, tetrachloroethylene, tetryl, vanadium, volak rodenticide poisoning, volid rodenticide poisoning, tobacco smoke
Dental Dental extraction
Dermatologic Benign mucosal pemphigoid, defibrination syndrome, leprosy, localized skin infection, melanoma, mucormycosis, nasal excoriation, Osler-weber-rendu disease, purpura, septal granulomas, staphylococcal furuncles, systemic lupus erythematosus, thrombocyopenic purpura
Drug Side Effect Allegra, anticoagulants, antiplatelet drug, aspirin, bicalutamide, budesonide, butorphanol, cefpodoxime, ciclesonide,clemastine fumarate, clopidogrel, caspofungin acetate, clove (herbal agent), desmopressin, diquat dibromide, febuxostat, fexofenadine, flurbiprofen, fluticasone nasal spray, heroin, histrelin, Ibuprofen, corticosteroids, ipratropium bromide, isotretinoinleflunomide, lenvatinib, loratadine, meropenem, metipranolol, miltefosine, narcotics, nasal steroids, olopatadine, oxcarbazepine, palbociclib, pennyroyal oil (herbal agent), pramipexole, prasugrel, ramucirumab, retapamulin, rifaximin, riociguat,romiplostim, sertraline, sulindac, telfast, tiagabine, thalidomide, tobramycin, topiramate, triamcinolone acetonide, trimethadione, valproic acid, warfarin
Ear Nose Throat Abnormal nasal anatomy , acute sinusitis, allergic rhinitis, antrochoanal polyps, antrostomy, barotrauma, benign nose tumors, broken nose, chronic irritation of the nasal mucosa, chronic rhinitis , chronic sinusitis common cold, deviated septum, dry nasal mucosa, epstein's syndrome, esthesioneuroblastoma, ethmoidal polyps, hereditary haemorrhagic telangiectasia, increased nasal venous pressure, intranasal rhabdomyosarcoma, inverted papilloma, juvenile nasopharyngeal angiofibroma, maxillary sinus carcinoma, maxillofacial injury, middle ear barotrauma, nasal cancer, nasal cannula, nasal colonization with staphylococcus aureus , nasal congestion, nasal diphtheria, nasal excoriation, nasal foreign body, nasal fracture, nasal infection, nasal obstruction, nasal polyp, nasal septum deviation, nasal sprays, nasal tuberculosis, nasopharyngeal angiofibroma, nasopharyngeal carcinoma, nasal ulceration, non-allergic rhinitis, nose picking, rhinitis, rhinoplasty rhinoscleroma septal deviation, septal perforation, sinonasal undifferentiated carcinoma, sinus tumor, sinusitis, superior vena cava syndrome, trauma to littlee's area, unilateral choanal atresia, viral rhinitis
Endocrine Acthar, cystic fibrosis, corticotropin
Environmental Cold air, dry air, environmental irritants, humidity
Gastroenterologic Cirrhosis, hepatitis, mucormycosis, progressive familial intrahepatic cholestasis, Banti's syndrome, rhinocerebral mucormycosis, rhinocerebral zygomycosis, Von Gierke Disease, Zygomycosis
Genetic ADP platelet receptor P2Y12 deficiency, autoimmune lymphoproliferative syndrome, Banti's syndrome, christmas disease, coarctation of the aorta, congenital afibrinogenemia, congenital hypoplastic anemia, congenital syphilis, Congential fibrinogen deficiency, connective tissue disease, cystic fibrosis, familial platelet syndrome, Fanconi's anemia, Hemoglobin Lepore syndrome, hemophilia, Hermansky-Pudlak syndrome, inherited coagulation disorders, leukocyte adhesion deficiency, May-Hegglin anomaly, Osler-Weber-Rendu Disease, Owren parahemophilia, progressive familial intrahepatic cholestasis, prothrombin deficiency, sickle cell anemia, Von Gierke disease, Von Willebrand disease, X-linked dyserythropoietic anemia and thrombocytopenia
Hematologic Acquired coagulation disorders, acquired factor XIII deficiency, acute erythroleukemia, acute leukemia, acute lymphocytic leukemia, acute promyelocytic leukemia, anemia, aplastic anemia, autoimmune lymphoproliferative syndrome, autoimmune thrombocytopenia, Bernard-Soulier syndrome, Bing-Neel syndrome, bleeding diathesis, bleeding disorders, bleeding tendency, blood dyscrasias, christmas disease, chronic leukemia, coagulation disorders, congenital afibrinogenemia, congenital hypoplastic anemia, congential fibrinogen deficiency, defibrination syndrome, Epstein's syndrome, factor V deficiency, factor VII deficiency, factor X deficiency, familial blood dyscrasias, familial platelet syndrome, Fanconi's anemia, hematological malignancy, Hemoglobin Lepore syndrome, hemoglobin SC, hemophilia, Hermansky-Pudlak syndrome, idiopathic thrombocytopenic purpura, Inability of the blood to clot, leukaemia, lymphomatoid granulomatosis, May-Hegglin anomaly, myelodysplastic syndromes, myeloproliferative diseases, Owren parahemophilia, pancytopenia, people with blood group O, platelet disorders, polycythemia vera, purpura, sickle cell anemia, stuart factor deficiency, superior vena cava syndrome, thrombasthenia, thrombocytopenic purpura, thrombocytopathy, thrombocytopenia, Von Willebrand disease, Waldenstrom macroglobulinemia, X-linked dyserythropoietic anemia and thrombocytopenia
Iatrogenic Adenoidectomy, antrostomy, dental extraction, endoscopic sinus procedures, facial surgery, nasal cannula, nasal surgery, nasogastric tube placement, nasotracheal intubation, Orbital decompression, postoperative, rhinoplasty, septoplasty, sinus surgery, turbinectomy
Infectious Disease Argentinean hemorrhagic fever, Bolivian hemorrhagic fever, congenital syphilis, dengue hemorrhagic fever, Hantavirosis, hepatitis, idiopathic fibrosing mediastinitis, infectious diseases, inflammatory disorders, leprosy, localized skin infection, Machupo virus, mucocutaneous leishmaniasis, mucormycosis, nasal diphtheria, nasal infection, Omsk hemorrhagic fever, nasal tuberculosis, pertussis, relapsing fever, respiratory tract infection, rhinocerebral mucormycosis, rhinocerebral zygomycosis, rheumatic fever, rhinoscleroma, rhinosporidiosis, scleroma, sinusitis, Stachybotrys chartarum, Soft tissue infection, Staphylococcal furuncles, Streptococcus pyogenes infection, systemic infection with nasal congestion, tuberculosis, typhoid fever, viral rhinitis, viral upper respiratory infections, Weil syndrome, whooping cough, zygomycosis
Musculoskeletal / Ortho No underlying causes
Neurologic Acute cholinergic dysautonomia, Bing-Neel syndrome, head injury, Osler-Weber-Rendu syndrome
Nutritional / Metabolic ADP platelet receptor p2y12 deficiency, clove (herbal agent), cystic fibrosis, excessive dieting, ginseng, glycogen storage disease, malnutrition, rapid weight loss, vitamin C deficiency, vitamin K deficiency, Von Gierke disease
Obstetric/Gynecologic Menopause, pregnancy
Oncologic Acute erythroleukemia, acute leukemia, acute lymphocytic leukemia, acute promyelocytic leukemia, adenoid cystic carcinoma, angiofibroma, chronic leukemia, esthesioneuroblastoma, hemangioma, hematological malignancy, Intranasal rhabdomyosarcoma, inverted papilloma, juvenile nasopharyngeal angiofibroma, leukaemia, maxillary sinus carcinoma, melanoma, myelodysplastic syndromes, myeloproliferative diseases, nasal cancer, nasal type natural killer/t-cell lymphoma, nasopharyngeal angiofibroma, nasopharyngeal cancers, nasopharyngeal carcinoma, neoplasm, pindborg tumor, polycythemia vera, rhabdomyosarcoma, Sinonasal undifferentiated carcinoma, squamous cell carcinoma, Waldenstrom macroglobulinemia
Opthalmologic Orbital decompression
Overdose / Toxicity Alcohol abuse, chronic usage of nasal sprays, chronic vitamin A toxicity, cocaine, heroin, narcotics
Psychiatric Aerosol abuse, alcohol abuse, child abuse, inhalant abuse, solvent abuse, volatile inhalants
Pulmonary Asphyxiation, barotrauma, common cold, cystic fibrosis, idiopathic fibrosing mediastinitis, pertussis, respiratory tract infection, sarcoidosis, Wegener's granulomatosis, Whooping cough
Renal / Electrolyte Chronic kidney disease, Epstein's syndrome, renal artery stenosis, renal dialysis, renal disease, systemic lupus erythematosus, Wegener's granulomatosis
Rheum / Immune / Allergy Allergic rhinitis, allergies, autoimmune lymphoproliferative syndrome, autoimmune thrombocytopenia|autoimmune thrombocytopenia, benign mucosal pemphigoid, immune thrombocytopenic purpura, leukocyte adhesion deficiency, polychondritis, rheumatic fever, rhinitis, sarcoidosis, systemic lupus erythematosus, Wegener's granulomatosis
Sexual No underlying causes
Trauma Barotrauma, blunt trauma, broken nose, facial trauma, head injury, maxillofacial injury, nasal fracture, post-traumatic pseudoaneurysm, Skull fracture, sphenoidal fracture, trauma to littlee's area
Urologic Inverted papilloma
Miscellaneous Foreign bodies, pennyroyal oil

Causes in Alphabetical Order

References

  1. ↑ Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
  2. ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID doi:10.1016/j.otc.2008.01.003 Check |pmid= value (help).

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