Pupura and petechiae

[Margot49]

I have not been well for some time and have seen a *multitude* of doctors/specialists.  Started with chronic dry mouth/throat, nausea, night sweats.  Anyway, I had broken out with petechiae and none of the docs I saw seemed to be concerned about it.  They are mainly on my upper arms and abdomen.  Some weeks ago, I noticed (what I looked up to be) pupura on my forearms. That is the only place I am seeing this, now.  I've seen this on older people, like my parents who are in their 80's and take Aspirin.  I am 62 and do not take any type of blood thinner. I don't know anyone else my age who has these things.  I don't know if this is something to worry about or not.  Of course, I had none last time I saw the doctor.  Now, I feel they should be checked but by which doctor; I';ve seen so many.  Do I go to my regular GP, the endocronologist or the oncologist?  I am tired of these docs telling me these things are nothing to worry about yet now this.  
Advice?

[Margot49]

Meant to add that I am still having night sweats and often will feel clamy during the day. I keep telling the docs this but they don't really discuss it or give me an answer.
I am 62 and went through menopause some years ago. These started again about 1 1/2 years ago now.

[Margot49]

I went to my doctor and asked him to do some testing and they drew about 6 vials of blood.  I did come back in the low range for B-12 so he has me taking 1000mcg daily and to be rechecked in December.  Other than that, he didn't find much out of wack.  I assume, if it were a leukemia or bleeding disorder, test results would have shown something.  Clotting was okay.  Actually, have not had the spots on my arms now for at least a week.
However, I continue to feel terrible and having a bad day today.  I feel kind of queezy again and, aside from the dry mouth and throat, my tongue just does not feel right along with the back of the soft palate.  My tongue often has a white coating on it.  I brush religiously.  I continue to have the,now chronic, feeling of the lump/thick mucus in my throat.  It is just horrible.  I have been running a humidifier at night but that makes no difference.  I just don't know what other doctor or type of doctor to go to. There is definitely something wrong and is not chronic and getting worse. Any suggestions would be appreciated. I think I am between the fields of ENT, GI and dental stuff but none of them seem to know what this is.  Everyone has tested and looked for the obvious stuff but I read about other tests and diseases I've never heard of and who tests for those that enables them to make diagnosis of those diseases?  I thought the endocronologist would handle this but she only tested for the thyroid and that immunofixation, which they say not to worry about.  There has to be an answer out there.  One just knows when something is not right and you just don' t feel well and things to continue to worsen.

[Mpittman1985]

I also have been feeling ill for quite some time starting when I got an IUD implanted and it caused many cysts. But thats nothing to do with my response to you. Have you heard of thrush? Its a fungal infection of candida (yeast) in your mouth. The white you speak of made me wonder. I am not a dr but I have been to so many that couldn't figure it out I gave up. But a chiropractor saw me, my stomach was so swollen I looked 9 months pregnant, but normally a very tiny lady. I was exhausted. I remember telling him I felt like a dead man walking. I was have short term memory problems, multiple UTIs, all kinds of stuff. He was the first to mention candida, he said he thought I have leaky gut which goes hand in hand with overgrown candida in the gut, candidiasis, or dysbiosis. Look that up, with your mouth it makes me wonder if you have it as well. Sometimes it can present in yeast infections or thrush in the mouth. I take supplements now for candida and many more others. I dont want to send you down a wrong path but look it up and see if that sounds like you. And if so make an appointment with a nutritionist that knows about leaky gut to get it worked out!

I hope that helps someone! It took me 18 specialists multiple times each and lost my gallbladder that I didnt need to lose if I had the answer sooner!

Get to feeling better, take care!

[Margot49]

Thank you for following this topic of discussion.  I hope to get my test results back some time this week.  I believe my doctor is testing my liver function and a few other things I requested he check for.  I can't say he was to receptive but he is running them and was looking up something on his laptop then asked me if I was having night sweats. I've been telling him for over a year I started having night sweats. I've told a number of doctors that. I am way past menopause.  I had looked up sarcoidosis before and don't believe I fit that criteria.  I was tested for GERD and treated for that by just about every ENT doctor I've seen.  The ENT doctor at Stanford said he did not believe that was the case and I had problems with Nexium and he is the only one that agreed I should not be taking that class of drugs as I have Osteo and had a rib fracture when I was taking that.  
I don't believe I know what you mean by tumor markers.  
My doctor is going to send the test results to both of the oncologist I've seen.  If I have to do follow up with an oncologist, I don't know which one to go to; that's another long story.  
I see the GI doctor tomorrow that did an endoscopy a couple of weeks ago but he told my husband he really didn't see anything.
Actually, this all started about 3 1/2 years ago around the time I had a bilateral oopherectomy.  For some odd reason, the anesthesiologist called me the following day to see how I was.  I was ok then about 3 hours after he called, I had bad stomach pain and nausea.  I was sick daily, lost around 40 lbs was prescribed Reglan, which I reacted to, Nexium, and this nightmare of a journey started. Actually, the beginning of the dry mouth issues started prior to the surgery but has worsen since then.  
I will keep you posted, if you like. Perhaps what I'm going through may help someone else.  

[Margot49]

Thank you for your response and I suppose it could be senile pupura, I did look that up.  However, I still have the petechiae, chronic dry mouth and throat and night sweats, all ongoing and getting worse.  

[Bhupinder Kaur, MD]

Hello,
If your blood tests have come back normal, then chances are less that there are blood clotting disorders. However the possibility of any liver function disorders and leukemias should be ruled out by liver function tests and tumor markers.

For the dry mouth since your endoscopies and thyroid and tests for Sjogren’s have come out normal, it can be due to anxiety, GERD or sarcoidosis - the inflammation of body tissue. So it is better to get evaluated for these possibilities from your physician.

I hope it helps. 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.

[maatson]

Looks like this is 'senile purpura' and nothing more.By the way i do not like this nomenclature of calling this 'senile' purpura since it can happen in mid-age too.This is benign and of no serious consequence.
Best wishes.

[Margot49]

Had 2 doctor appts yesterday. Follow up with my ENT who scoped me again and basically sees nothing. At a loss as to the dry mouth and throat and the feeling of a lump in my throat.  It's miserable.  :-(
Had an appt with my GP yesterday and told him I wanted to have a *serious* discussion and showed him the spots on my arms and torso. He tried to tell me his wife gets them too. I reminded him, again, that I am still having problems with night sweats.  I cited the problems I have been having for some time and had written down some testing that was recommended.  He finally agreed to order some blood work so they drew 6 vials of blood.  I hope it is nothing serious but he is going to send the results to the two oncologist I've seen. Thank you for the help and advice.  After over a dozen doctors, maybe they can figure out something.  

[Margot49]

Meant to add, I've had soooooooo many blood tests done, last time pre-op before a cardiovascular angiogram, wouldn't something show up if it were
thrombocytopenia, ITP or leukemias. ?

[Margot49]

Thank you for the response.  I started getting the petechiae some time ago and have shown a few of the doctors I go to and they all said it was nothing to worry about. One said the larger ones were cherry hemangiomas.  I rather recently started getting the purpura.  I did go to a  dermatologist last week and the PA that saw me (for something else also) said I should see my doctor about the purpura.  I have not been well for some time and have been to numerous doctors, mainly due to dry mouth and throat and feeling of lump in my throat. Have another appt yet tomorrow.  I went to an endocronologist for thyroid nodules and cysts and had a second biopsy - benign.  My thyroid tests are always normal.  However, she did an immunofixation test, which I never heard of, and it came back
The results showed
Immunofixation studies revealed TWO trace concentration band(s)
migrating in the GAMMA region which appear(s) to type as IGG LAAMBDA
monoclonal protein(s).

Also noted was ONE trace concentration band(s) migrating in the GAMMA
region which was/were of too low a concentration to definitively
identify.

She said it was nothing to worry about but referred me to an oncologist.  I went to my mother's doctor who basically told me they look for/worry about higher readings and to come back in a year to be retested.  I didn't have the purpura at the time.

My GP thinks all this is due to anxiety and loves to prescribe anti-depressants, which I don't take. I have taken a low dose of Alprazalom for about 3 1/2 years (1/2 .5 mg  tab once or twice a day).  

I was thinking of maybe trying to get in to see my own doc again or get another oncologist opinion?  I just have not felt well for a long time and started getting night sweats about 1 1/2 years ago - I am way past menopause.  

It is just discouraging as these docs are always in a hurry, don't know what to do with me and really don't seem to listen.

I see a GI doc on Monday to get the results of yet another endoscopy that was done.  He told my husband he didn't really see anything.  All the ENT docs I've seen treat me for GERD, which I really don't have.  I ended up having problems with long term Nexium use so can't take those anyway as I have Osteoporosis which the endo doc prescribed 2000units of Vit D a day.  

So far, the pupura has only been on the tops of my forearms, mainly my left one but I don't see anyone else my age (62) with this.  As I said, my doc told me to take a daily Baby Aspirin but I stopped that over a week ago.

Would you suggest I see my own physician or try to get into another oncologist?  

This dry mouth/throat problem has me almost house-bound.  I've had two biopsies and blood tests for Sjorgens - negative.

[Bhupinder Kaur, MD]

Hello,
If you are having petechiae, purpura or ecchymosis and these need immediate evaluation. Ecchymosis is a subcutaneous hematoma larger than 1cm. Petechiae are pinpoint-sized red dots under the surface of the skin. They are common after skin trauma and viral infections and usually blanch with pressure but they don’t go away completely. They should go away in a few days. But if they persist then please consult a physician and get other causes ruled out which include allergic reaction, autoimmune diseases, thrombocytopenia, ITP or leukemias.

My sincere advice is to get it examined from a dermatologist. 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.