Unexplained Bruising and Bleeding, Severe Bleeds

[Cortana117]

I am nineteen years old and was found to be anemic when I gave blood two years ago and my iron levels were horrid. Every time I have given blood (three times), I experienced a hematoma at the needle injection site, which lasted for a few weeks following donation. I experience very heavy menstrual cycles which can last over a week non-stop and unrelenting. My cycles range from every 28 to every 20 to every 34 days. Sometimes I experience two a month. (I have had them since I was 10). I bruise very easily and for extended periods and my scabs are always very thin. In the heat, I experience small blood spots all up and down my arms and legs.. I bleed severely from minor scrapes or cuts. Sometimes when I crack my knuckles or joints on my fingers (it's a nervous habit) I develop a bruise there. I bleed from my gums when I brush my teeth even though my dentist has confirmed my teeth and gums are perfectly healthy. I get nosebleeds about once a month. I am 5'7" and 150 pounds, if weight matters. My blood pressure is always perfect. I walk a mile per day. I eat right, vegetables and fruits and all the good things. I have a cookie or a double cheeseburger from time to time but my diet is good. I don't know what could be wrong. Does anyone have an answer?

[Cortana117]

Results are back. The aspiration came back negative for things. However, I was told that I have itp and need to take steroids. I also have to limit physical activity. Apparently this can be serious. So hoping for the best. Hoping it goes away

[Bhupinder Kaur, MD]

Hello,
Thrombocytopenia is a reduced platelet (thrombocyte) count. It happens when platelets are lost from the circulation faster than they can be replaced from the bone marrow where they are made. It results from failure of platelet production and increased rate of removal from blood.

I suggest you to consult a hematologist and get this evaluated.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Cortana117]

Dr. Bhupinder,

Thank you for your help. I visisted the doctor on Monday and was welcomed by many blood tests and a bone marrow aspiration. Quite the uncomfortable procedure, might I add. He wishes to check for leukemia and a few other disorders that I cannot remember all the names of. The list was quite long.

My hemaglobin was 9.8, which he said was fair.
My leukocyte number was good, according to the CBC.
My thrombocyte count was 28,000. *He told me this was way below average. I was given some steroids to take until the results of the aspiration come back (hopefully soon?).

I don't want a transfusion or anything but I guess I will do what I must, right?
Thank you for your concern.

[Bhupinder Kaur, MD]

Hello,
Anemia and deficiency of vitamins C, K, B12, or folic acid are the common causes of easy bruisability.Try taking iron tablets and multivitamins for some days and see if the symptoms improve.
If the symptoms do not improve, get yourself evaluated by a physician and look out for SLE, bone marrow disorders, bleeding disorders, liver diseases or leukemias. Anti-clotting (anti-coagulants) medication also can cause increased bruising.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Red_Star]

Symptoms of bleeding disorders may include:

Easy bruising
Bleeding gums
Heavy bleeding from small cuts or dental work
Unexplained nosebleeds
Heavy menstrual bleeding

Causes include:

Coagulation factor disorders:

Haemophilia A - factor VIII deficiency
Haemophilia B - factor IX deficiency (Christmas disease)
Von Willebrand disease
Vitamin K deficiency
Liver failure
Drug: Heparin
Disseminated intravascular coagulation (DIC)
Coagulation factor anticoagulant: Lupus anticoagulant
Fibrinolytic states - tissue plasminogen activator (t-PA), streptokinase, urokinase, liver & prostate cancer

Platelet disorders:

Thrombocytopenia (decreased platelet count) - see wikipedia for numerous causes
Platelet dysfunction (prolonged bleeding time): congenital, thrombocytosis, drugs: aspirin, persantin

Vascular defects (non thrombocytopenic purpura):

Senile purpura
Cushing's syndrome
Drugs: steroid, aspirin, penicillin, sulfa
Schonlein henoch purpura  
Infectious purpura: meningococcemia, virus, septicemia, subacute bacterial endocarditis
Hereditary haemorrhagic telangiectasia
Scurvy (vitamin C deficiency)
Dysproteinemia: macroglobulinemia, cryoglobulinemia, myeloma
Fat embolism