Coagulation Issues: Bruising, Bleeding, and Anemia Concerns

Coagulation function

Hello Doctor: Recently, I have been experiencing unexplained bruising on my legs and numerous petechiae under the skin.
In late September, I underwent a complete blood count, which showed anemia but normal results for everything else (I have thalassemia).
In October, due to frequent joint pain, I consulted a rheumatologist who performed blood tests and mentioned that I have abnormal cryoglobulins, which could explain the easy bruising, but said it was not a concern and that I should just monitor it.

A month later, my coagulation function remains poor; I have noticed easy bleeding from my gums and non-menstrual bleeding (I consulted a gynecologist who said it was ovulation bleeding), and I experienced bleeding after intercourse (my menstrual flow is usually normal, lasting about 6 to 7 days).
This has never happened before.
In early November, I visited the hematology department at Linkou Chang Gung Memorial Hospital, but the doctor was dismissive, stating that since I had blood tests done in late September, there wouldn’t be significant changes in just two months.
He said that as long as I wasn’t experiencing uncontrolled bleeding, I could just observe and return for blood tests in two months.
Could my symptoms be due to the abnormal cryoglobulins? These past few months have been very distressing for me.
What is happening to me? I have been very anxious, and I have lost 2 kilograms in weight over these months, along with persistent diarrhea.
I even underwent a colonoscopy.
I am particularly worried because my mother passed away from leukemia, and there is a family history.

Niming, 20~29 year old female. Ask Date: 2017/11/15

Dr. Hu Ziren reply Oncology

I recommend that you go to the hematology department for a follow-up examination; however, leukemia does not have a hereditary tendency, so there is no need to worry too much.

Reply Date: 2017/11/15

More Info

Hello! Thank you for sharing your concerns regarding your health issues, particularly the bruising, bleeding, and anemia symptoms you've been experiencing. It sounds like you have been through a lot recently, and it's understandable to feel anxious given your family history and the complexity of your symptoms.

From what you've described, it seems that you have a few interconnected issues that could be contributing to your symptoms. The presence of easy bruising and petechiae (small red or purple spots on the skin) can often indicate a problem with blood clotting or platelet function. Given your history of thalassemia (Mediterranean anemia), it's important to consider how this condition might be affecting your overall blood health. Thalassemia can lead to anemia, which can in turn cause fatigue and other systemic symptoms.

You mentioned that you have been diagnosed with abnormal coagulation proteins, which can indeed lead to increased bruising and bleeding. Conditions that affect the coagulation cascade can result in a variety of symptoms, including easy bruising, prolonged bleeding from cuts, and unusual bleeding patterns, such as the non-menstrual bleeding you described. It’s crucial to follow up with a hematologist who can provide a more thorough evaluation of your coagulation profile and determine if there are any underlying conditions that need to be addressed.

The bleeding from your gums and the unusual bleeding after intercourse are also concerning symptoms that warrant further investigation. While the gynecologist suggested that the bleeding could be ovulation-related, it’s essential to rule out any other potential causes, especially given your history of coagulation issues. Hormonal imbalances, infections, or even structural issues within the reproductive system could also contribute to abnormal bleeding patterns.

Your anxiety and weight loss, along with the gastrointestinal symptoms like diarrhea, may be exacerbating your overall health condition. Stress can have a significant impact on physical health, and it’s not uncommon for individuals dealing with chronic health issues to experience anxiety and changes in appetite or weight. It might be beneficial to explore stress management techniques, such as mindfulness, therapy, or support groups, to help you cope with the emotional toll of your health concerns.

Given your family history of leukemia, it’s understandable that you are feeling particularly anxious about your symptoms. Family history can play a significant role in the risk of developing certain blood disorders, and it’s important to communicate this history to your healthcare providers. They may recommend more comprehensive testing or monitoring to ensure that any potential issues are caught early.

In summary, your symptoms of easy bruising, bleeding, and anemia could be related to your underlying thalassemia and the abnormal coagulation proteins. It’s crucial to continue working with your healthcare providers to monitor these symptoms and investigate further. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion from another hematologist or a specialized clinic that focuses on coagulation disorders. Your health is important, and you deserve thorough and compassionate care. Please take care of yourself, and don’t hesitate to reach out for support from friends, family, or mental health professionals as you navigate this challenging time.

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