Easy bruising

I normally just use a full blood count to investigate easy bruising; I’ve ummed and ahhhed about getting a clotting screen as well, but it seems like overkill to me. However, the authors of an article in the latest BMJ advise that not only should I also be doing a clotting screen, including INR (I thought that was automatically included, but they list it separately), but I should also add a blood film (for platelet abnormalities) and renal and liver function tests (renal impairment can cause acquired platelet dysfunction, and liver failure can also lead to platelet dysfunction as well as, of course, reduced clotting factor production).

Also, a point worth remembering; easy bruising or bleeding can be caused by nutritional deficiency, as a result of gastrointestinal problems or of poverty. (Vitamin C leads to collagen defects and hence to defects in blood vessels; Vitamin K deficiency means decreased clotting factor synthesis.)

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About Dr Sarah

I'm a GP with a husband and two young children.
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