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What Causes Bruising On The Arms While On Plavix?

Posted on Mon, 17 Jul 2017

Question: I had CVA approximately 6-8 weeka ago Rx for Plavix 75 and ASA 81 first few days small amt buiising within 5 days severe bruising all over arms on chest genital area covered tops of leg call PCP to see him immediately He had never seen anything like it called associate,same Sent to ER for ct scan normal, LFTs normal and platelets normal what is your dx

Answered by Dr. Prof. Kunal Saha (4 hours later)

Brief Answer:
Please upload an image

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query carefully and understand your concerns. However, I would insist you to upload an image of the affected area. You can upload the attachments using the facility on the upper right of this page. Alternatively you can email the attachments to YYYY@YYYY with the query id 337744 and my name mentioned in the subject. It will help me to evaluate the possible cause.

I would also insist on getting a coagulation profile of blood done. It will help in identification of the cause. I do not expect the platelet count to be decreased.

It is possible that plavix and ASA have reduced the platelet function thus causing petechial bleeding under the skin. I would be able to suggest more after checking the image.

I would await your response. Let me know if I could help further.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (11 hours later)

no petechial bruising each bruise larger than fifty cent piece. no bm since Tuesday until about 2hrs ago hematest positive and severe pain at crease of left hip to toes almost unable to work Really has me worried! any suggestion, pls answer asap lorine coag studies ok in hospital INR 1.0

Answered by Dr. Prof. Kunal Saha (13 hours later)

Brief Answer:
Please upload an image

Detailed Answer:
Thanks for the update. It is quite apparent that the platelet function has been affected even though the platelet count or INR is unaffected. I would insist you to upload an image of the patches. Since the coagulation profile is ok you can wait and watch. The patches would possibly take a week or so to resolve and they would resolve on their own. You would need to be patient.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (18 hours later)

How can you be patient when possibility of another CVA, I am scared to death I am not on blood thinner and no one has heard of reaction to Plavix, I have been nurse for 45 years and knowpetechia is . All coag studies normal Dr called in someone else and he could not identify Do you think I am subject to another CVA I am still bruising and blood in stool , going back to PCP tomorrow. I have to have answer Asap or I will go crazy!!!!!

Answered by Dr. Prof. Kunal Saha (21 minutes later)

Brief Answer:
Something seems to be wrong with your coagulation capacity

Detailed Answer:
Thanks again for writing back. The mentioned presentation is not that of a CVA and therefore I would not consider another CVA to have occurred. Could you specifically let me know the aPTT value from the coagulation study? A repeat coagulation study could also be advisable. It is quite certain that the capacity to stop bleeding (coagulation) has been compromised. A detailed workup is needed and you definitely need to go back to your PCP.

You have still not uploaded the images of the affected areas. I would insist you to try to relax. Worrying will not make things better. I am certain that your PCP would be able to look closely and resolve the issues.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (38 minutes later)

Will seePCP tomorrow at 2pm.I know he will repeat coag and will ask for PTT Thanks for advise and will stay in touch.

Best,
Lorine

Answered by Dr. Prof. Kunal Saha (1 hour later)

Brief Answer:
Thanks for the update

Detailed Answer:
Thanks for the updates. Let me know what happens next. I will be there to assist you.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (19 hours later)

I am dragging! Saw PCP today and gave me a complete exam. Hematest positive have to set up apt with Gastro in few days, had normal colonoscopy in March 2017, all coag studies normal inc PTT. I think he is puzzleded but doing all the right if I can stand to go thru anymore. I am still weak from CVA and impairment to left, have to lift leg out of car , difficulty climbing stairs, just plain worn out and worried
Many thanks

Answered by Dr. Prof. Kunal Saha (5 hours later)

Brief Answer:
Careful correlation required

Detailed Answer:
The condition is indeed perplexing. You might benefit from this journal publication (warning: technical contents) http://www.yyyyy.yyyg/yyy/00000/0000/00000.html

Talk to your doctor and see what he can come up with.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Prof. Kunal Saha (44 hours later)

How may I purchase this journal ?

Many thanks

Answered by Dr. Prof. Kunal Saha (8 hours later)

Brief Answer:
Link to full text article provided. You can take a print.

Detailed Answer:
Do you really need to purchase the journal? I have provided the link to the full text page of the article. You can simply take a print if you want.

If you still need a copy of the journal you can place your request through http://www.aafp.org/home.html and they will be able to tell you whether the back issue is available.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (9 hours later)

Its me again, many thanks for your expertise advise, has been very helpful, I am on my last leg. did not go to bed at all last evening. Severe pain left quadrant, radiating to left leg down to toes. So painful unable to walk, hold ing on to stairway top rail and sliding to end. Have severe urinary incontinence, urinating all over self and running down legs leaving trail of urine all down hallway. Wear diapers and liner, had to bath, redress for bed and scrub floor with scented cloths. Still having pain. Called PCP advised 2 Tramadol plus two Tylenol Really feeling lousy today, have been in recliner most of day with feet elevated as feet and ankles are swollen tight (4+edema).I am at wits end , unable to get positive diagonis. Do I have any other options as I feel like I might expire. PLease let me hear from you promptly.

Best,
Lorine Brown

Answered by Dr. Prof. Kunal Saha (15 hours later)

Brief Answer:
Get an USG of whole abdomen done. Upload report.

Detailed Answer:
I understand your agony. Sorry for the inadvertent delay in responding. Tramadol Plus should provide relief. However, the overall condition calls for a thorough clinical evaluation. The symptoms point to a liver cause. The liver synthesizes the proteins that keep the water within the blood vessels thus preventing development of edema. The clotting factors are also synthesized by the liver. So, the cause seems to be localizing to the liver. I would insist you to get an ultrasonogram of whole abdomen (if not done already) and to upload the report. Based on that I will try to guide you further.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar