Bleeding Gums, bloody nose- away at college

[trish148]

My college age daughter called me a few weeks ago to explain a strange happening.  The previous night she was at a party and her nose just started bleeding spontaneously.  She had to leave the party and it took about 15 minutes to stop it.  It happened one more time.   I also found out that her gums had been bleeding when she brushed her teeth.  She hasn't gotten any more bloody noses, so I stopped checking in on her about it.  She was just home and showed me how much her teeth bleed when she brushes her teeth.  Her gums look all red and bleed pretty much.  I've never seen anything like it.  She just had a dental cleaning in August.  Of course she showed me this as I was about to drive her three hours back to school after the Thanksgiving break.  I am now going crazy about this since she won't be home for another three weeks.  She has had about three viruses this semester (which is a lot for her, but she is living in a dorm).  Her lymph nodes in her neck were swollen one time, but I haven't checked lately.  She said she is feeling pretty fine otherwise.  No sweats, no weight loss, no loss of appetite, tired (but she's a college student).  She wasn't pale, had the red lines in her palms like normal.  She said she has a few bruises, but nothing totally abnormal for her.  She's always had very irregular menstrual cycle.  Bleeds about every two weeks.  Seeing a gyn soon for first checkup.  
I sent her a spin brush, floss and salt (to make salt water rinse).   I googled bleeding gums and saw it at the top of the list of symptoms for leukemia along with bloody noses, frequent infections so my mind is jumping to this.  Very stressful with her being away so I don't know what to do.  Does this sound like something I need to have her go to the health center asap?

[Hien K Duong, MD]

Trish148,

I apologize for my delayed response.  I’m glad that your daughter went to the health center, it’s a good place to start.  It’s not uncommon for students moving away to college for the first time to have frequent infections (living in close quarters to many other students, changes in diet and sleep patterns, and a number of other things that may affect her immune system).  

Although bleeding gums can be associated with leukemia, it is rare.  Also given her young age, I sincerely doubt that she has leukemia.  However if her symptoms of bleeding or easy bruising persist/worsen, she should have initial blood work done, as summerluvr mentioned, most importantly a CBC (complete blood count) which would include the white blood cell count, hemoglobin/hematocrit, red blood cell indices, and platelet count.  This will give useful information regarding potential causes and definitively exclude leukemia.

It’s not uncommon for young females, who are menstruating heavily/frequently, to be anemic (have low hemoglobin/hematocrit) and this will be evident on her blood tests.  If she is anemic for this reason, it could be adding to her fatigue; iron supplements may be helpful.

It may be a good idea for her to see her dentist again as well. Thanks for the question and please keep us updated.

[trish148]

Just an update, in case anyone has a similar problem.  My daughter went to the health center and was seen by a doctor.  He said that because the gums have stopped bleeding after attentive cleaning, they are not a symptom of a bleeding problem.  If it was, vigorous cleaning would cause them to continue to bleed, if not worsen.  Fever & cough probably a virus (neg for flue) and she has gotten very run down with being away at school for the first time.  If fever and cough persist she is to return to health center.

[summerluvr]

She needs to go the health centre and ge some basic blood work!  CBC, and platletts and rion levles etc. will help figure out what's up.  Symptoms alone aren't a great way to diagnose  because there are so many things that cause similar symptoms, some more benign then others, so before getting too worried you need to get some more information!

[trish148]

Just an update, in case any one wants to weigh in.  I am still very worried.  She has had a cough for about two weeks and just started with late day fevers (two days 100 and 101).  With the vigorous brushing/flossing cycle, the gums seem to have improved greatly.  She had one bruise about the size of a baseball but that has healed and she hasn't had any more.  Resting pulse 78 (not sure if that matters or if I'm just obsessing).  Hopefully she will go to the health center at school today.