Daughter bruising for no reason - abnormal bloods- can anyone help interpret the results please?

[FoxInABox]

My GP is off today so I’m booked in for a call Monday to discuss - can anyone help me to interpret these results and what the next course of action should be? I feel like I’m going to worrying all weekend and I’m also worried the GP didn’t seem concerned when he sent her for the tests so I just want to make sure that she gets the correct further tests or treatment that’s needed.

My teenage DD has been developing large bruises on her legs for no reason, along with small bruising that makes the tops of her thighs look mottled with bruises (best way I can think to describe them). She has lost a bit of weight recently but I put that down to her being on a bit of a health kick. Only other health concerns are she has had stomach pains for around 3 years now which also correlates to when she started her periods. She’s had a few bloods done for that in the past but nothing has flagged up and the doctors have then just said it’s IBS despite no issues with her bowel movements. GP wasn’t particularly worried about the bruising and felt that she must just be knocking her legs on things.

She has just had bloods done which came back with a few abnormal results - low lymphocytes 1.0, as well as abnormal aptt 32.0 and thrombin time 24.6. Aptt ratio was normal. Her prothrombin was within the normal range. Her vitamin D was just below the normal range at 48. Everything else was in the normal range (liver, renal, FBC, thyroid, serum ferritin & iron, hb1Ac - all normal range).

is there any obvious cause for these results? What should the next steps be? I feel like I am going to worrying about this all weekend but the receptionist said she couldn’t get another gp to call as there were no slots left.

I will be so grateful for any help or advice at all.

I'm sorry. I'm not medical so can't interpret the blood tests for you but has anyone mentioned the possibility of coeliac disease?

She had a blood test for that last year which was fine so they ruled that out

Could it just be down to vit d deficiency?

@FoxInABox
with the abnormal aptt and thrombin time, I’d be pushing for more tests for Von Willebrands and/or Mild-moderate haemophilia. Especially with the unexplained bruising.

How old is she? Has she started her periods?

put it out of your mind until your appointment with the GP on Monday. Easy to say, I know.

Everyone you find yourself thinking about it, just remind yourself that you are not going to think about it until then.

good luck.

OP how are her periods? Heavy or light? Does she get frequent nose bleeds? Is she hyper mobile?

@howchildrenreallylearn She’s 14, started her periods three years ago. Thank you I will ask them to do some further tests for those.

@FinallyHere I know I need to, I wish I had been able to speak to them today as just knowing the next steps would’ve made me feel a lot better. Luckily we are quite busy this weekend which will help

@springbringshope They are quite heavy and sometimes last a long time - they can be quite irregular too, she has tried the pill to regulate them and unfortunately she still had her periods whilst taking the pill. She isn’t hyper mobile but does have osgood schlatter pain in her knees, she doesn’t have any nosebleeds though luckily. The vitamin d deficiency surprised me as she has a good diet and regularly eats vit d rich foods, she’s also outside a pretty normal amount of time too, she plays a sport that is outside etc, though I guess the weather hasn’t been great until recently so hopefully that improves further.

Thank you everyone, really appreciate you all taking the time to reply. I want to make sure I’m asking the right questions on Monday so this is really helpful.

My daughter has the same. She’s absolutely covered with bruises but her blood tests were fine apparently. She’s also now covered in a blistering rash. Nobody seems to know what it is.

@Scutterbug i hope you get some answers, it’s really worrying not knowing what is going on. Is the rash painful?

Heavy periods in adolescence can be a sign of a mild- moderate bleeding disorder such as Von Willebrand’s so I’d definitely be asking about that.

Have you read up on hypermobile ehlers danlos? It can cause easy bruising

Thank you, yes the rash is really painful.

No, will have a look!

As she has abnormal results I would guess the GP will refer to Haematology.

Clotting is ridiculously complicated and I'd expect your GP won't be able to answer many of your questions as this really is one for a specialist.

Il be interested to know if it fits, the slogan is “can’t connect the issues, think connective issue”

@Scutterbugthe rash could be MCAS (mast cell activation syndrome) which is closely linked to hEDS (hypermobile ehlers danlos syndrome)

@AnnaMagnani thank you, that would put my mind at rest to have a specialist in this area checking everything, I hope they do refer her on.

I don’t think that fits her. She’s not hyper mobile. She’s 20 and this has all happened in the last few months.

Thanks. Just read up on it but I do t think it is that.

Taking any medication?

Dd got weird bruising like symptoms from mefenamic acid

When my daughter kept bruising for no reason it turned out her platelet count was practically zero. You didn’t mention platelets, were they within the normal range? Good luck for Monday.

Not sure if it's vitamin D, I had a really low vit D in my blood test but that was the single test for vit D itself, all my other bloods were within range. I had a list of all bloods and it said vit D (low number) out of range. Sorry I can't be more helpful.