Inquiries About Additional Testing for Unexplained Bruising and Lumps
**Do I need to request further tests? What could be the underlying cause of my symptoms?** I am a 36-year-old Caucasian female, a non-smoker, who doesn't consume alcohol or use recreational drugs. Below are my existing medical diagnoses, allergies, and medications. **Presenting Concern:** I have been experiencing excessive bruising, often arising from trivial incidents like scratching an itch, which leads to dark bruises. Some of these discolorations are painful while others are not. Although most bruises dissipate within the usual timeframe, there is one particular bruise on my left shin that has raised my concern. This bruise is a light yellow hue, accompanied by a painful lump beneath the skin that has persisted for about 2-3 weeks; the discomfort remains constant without any improvement. Additionally, I have a small, painless lump on my upper right thigh that has been present for roughly a year; my physician suspects it could be a cyst based on its depth assessed during a physical examination. Furthermore, I've experienced sporadic allergic reactions presenting as welts, hives, a scratchy throat, and severe itching, which seem to lack identifiable triggers or common allergens. **Noteworthy Test Results:** The only abnormal test finding has been an elevated MPV level, consistently ranging from 11 to 12 over two years. **Medical Conditions Diagnosed:** - Ehlers-Danlos syndrome - MTHFR gene mutation - Fibromyalgia - Eczema/Psoriasis (diagnosed through visual inspection without biopsy confirmation) - Polyarthritis - POTS - PSVT - Mild diastolic dysfunction due to basal septal hypertrophy - Moderate late systolic mitral valve prolapse, accompanied by moderate mitral regurgitation - Eosinophilic esophagitis - Endometriosis (hysterectomy performed, one ovary remains) - ADHD - Depression - Anxiety **Current Medications Include:** - 20mg extended-release dextroamphetamine-amphetamine once daily - 10mg dextroamphetamine taken twice in the morning and once in the afternoon as needed - 200mg Celecoxib once a day - 300mg Gabapentin three times daily - 60mg extended-release Propranolol once daily **Known Allergies:** - Antihypertensive medications (such as Lisinopril) - Medical adhesives, including glue and tape I would appreciate any guidance on potential tests I should consider or thoughts regarding the causes of my symptoms.
Answers (1)
3/25/2025, 2:30:54 PM
OpenHealth AI
Summary: Your symptoms of unexplained bruising, painful lumps, and a history of multiple medical conditions warrant further investigation. Elevated MPV levels may suggest a bleeding disorder or platelet function issue. Here’s how to proceed.
Explanation: Excessive bruising and the appearance of lumps can arise from various factors, particularly in individuals with underlying connective tissue disorders like Ehlers-Danlos syndrome, which can cause blood vessels to be more fragile. Your experience of consistent bruising, particularly from minor impacts, might relate to this condition. The painful lump under the bruise could indicate a hematoma (a localized collection of blood outside of blood vessels) or another inflammatory response. Given the persistence of these symptoms, it’s important to explore potential underlying causes more deeply.
Next Steps:
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Monitor Your Symptoms:
- Keep a record of all bruises, including their location, size, and any associated pain. Note any new lumps or changes in behavior of existing ones. This will provide useful information if you seek further evaluation.
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Request Specific Blood Tests:
Consider asking your healthcare provider for the following blood tests, which may help clarify your condition:- Complete Blood Count (CBC): To evaluate your blood cells and check for anemia or a clotting disorder.
- Coagulation Studies (PT, aPTT): To assess your bleeding and clotting ability.
- Platelet Function Tests: Given your elevated MPV, these tests can help evaluate how well your platelets are functioning.
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Evaluate for Vascular Health:
- Discuss with your doctor the possibility of vascular imaging, such as a Doppler ultrasound, to examine the blood vessels in the areas where you have experienced bruising and lumps.
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Address Allergic Reactions:
- Continue to monitor and identify any patterns in your allergic reactions. An allergist's consultation could be beneficial if symptoms persist or worsen.
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Educate Yourself about Your Conditions:
- Research Ehlers-Danlos syndrome and its complications, especially concerning bruising and vascular health. Understanding your conditions may empower you to manage symptoms and advocate for your health effectively.
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Follow-Up:
- Schedule a follow-up appointment to discuss the findings from your monitoring and any tests you pursue. Open communication with your healthcare provider is crucial in managing your diverse health needs.
Feeling anxious about these symptoms is natural, especially when they seem unexplained. By taking systematic steps and seeking appropriate tests, you’re actively participating in your health management. If you have any further questions or need clarification on these steps, feel free to ask.
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