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.

Interestingly my gums have been bad as well.

I’ve been suffering cluster headaches hence the blood test to check my hormones and thyroid just to check they are ok as gums can be a sign of menopause. (I have my ovaries and no uterus so have no idea if I’m menopausal iyswim?!)

Vitamin D has made me feel much better.

if her glands are up there’s a good chance she’s fighting something which could account for WBC count being low.

worthwhile also every question though as it may not all point to something else but just one of the results could tell a bigger story

@itsgettingweird ah that is interesting. I’m glad you’re starting to feel better. I think il get her some vitamin d tablets to see if it helps.

If you post misleading medical things you should expect to be corrected, that’s all. It’s nothing personal! I hope you have a good day too.

No mention of PCOS? I have this and with vitamin d deficiency. Bruises do take a while to heal and I'm on prescribed medication. My blood results were similar in the sense my liver, renal, FBC, thyroid, iron, b12 all normal range too.

Not to frighten anyone, but bleeding gums, bruising, weight loss. What's the first thing that most people think of. The L word hasn't been mentioned yet, or maybe I missed it.

It's a worrying time and I hope it all turns out to be a treatable condition.

@vandellevery unlikely if the other bloody counts are clear.

The L word hasn't been mentioned due to none of the bloods suggesting it in any way.

Nice to see such helpful posts. I have no medical skills at all, so can't comment op, but I hope you get some results.

@LemonadeQueen she did have hormone testing last year which they said was all normal levels but certainly something to consider.

@Oblomov25 thank you. I agree it’s been really helpful, given me a lot to consider.

Just noticed her transferrin saturation index is potentially low at 10% - it’s not noted as abnormal or normal on her results so didn’t notice before. Her iron levels and serum ferritin are normal. Not sure if that helps with possible explanations?

Low Transferrin is a strong indicator of anemia. (Fits with her heavy periods too).
Probably more important than the ferritin and iron results (although they are read together). I’m surprised they’ve not flagged that up. 10% is very low. What were her haemoglobin and ferritin?

@howchildrenreallylearn serum ferritin was 13.7 ng/ml
Serum transferrin 2.9 g/l
Serum iron level 8.3 umol/L

the Gp rang earlier and has requested advice from the haematology department at our local children’s hospital, he said he should hear back in the next few days whether they want to see her or just want him to repeat tests or order new tests. I brought up the low transferrin saturation index and he said as the other levels are normal she’s not anaemic and doesn’t need iron, but reading up online it sounds like it is a functional iron deficiency?
I’m hoping hematology flag it as he said he’s sent them all of her results, or hopefully she is referred to them so I can discuss it with them.

@howchildrenreallylearn sorry I missed out haemoglobin estimation was 142 g/L MCH 30.4pg

I’m not a medic so don’t take my advice as professional advice but I do have a lot of personal experience with anaemia results and I would say these scrape into the normal range, they are very low (though her hb seems ok).

It’s good you’ve been referred so you can get some specialist advice. I’d be really pushing for repeat bloods for both anaemia markers and for possible bleeding disorders if it was my child.

Aa an aside if they won’t give her iron I’d be getting her some at home. Something gentle like Floradix or the Better You spray. But wait until she’s seen haematology. All the best x

@howchildrenreallylearn thank you I appreciate it, I will most definitely be pushing for further tests.

That’s good the GP has asked advice from a specialist.

🤞 you get a plan soon of where to go next

@itsgettingweird thank you I hope so 🤞

Don't give her iron before you have seen haematology or you will skew any tests they may take. Her haemoglobin is fine anyway.

@Iwantmyoldnameback good advice thank you.
they've asked for the tests to be repeated as there is a good chance they’ve been contaminated so we’ve got a bit of a wait now for her new appointment for bloods

@verysmellyjellyhttps://www.nhs.uk/conditions/ehlers-danlos-syndromes/

@FoxInABox have you got to the bottom of this yet?

@howchildrenreallylearn she’s booked back in for bloods May 1st. She is still getting lots of bruises on her legs only. I feel quite relieved though as it’s looking likely the sample was contaminated but it doesn’t give us an answer on why she’s bruising.