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What Causes Easy Bruising While On Lemtrada And Gilenya?

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Posted on Tue, 27 Jun 2017
Question: I was diagnosed with MS in 2004. The current treatment that I am on is Lemtrada, before this I was on Gilyena. While I was on the Gilenya and currently have red bruises on my arms that appear with even the slightest bump, scratch etc. When I get nicked on my arms the skin tears and bleeds easily. I've been to a hematologist and nothing abnormal. I am only 53 years old, too young for skin thinning and bruises. What could be the cause of my bruising. I'm so tired of my arms looking like a battle ground

It would probably be helpful if you knew the other medications that I am on.
Estrodial 1mg daily
Fluoxitine 40 mg daily
acyclavere 2 daily
omeprazole 40 mg daily
trazadone 20 mg 2 at night
doctor
Answered by Dr. Lekshmi Rita Venugopal (4 hours later)
Brief Answer:
Causes of easy bruising

Detailed Answer:
Hello,
Thank you for the query at HealthcareMagic

I have gone through your query and seen the reports attached.

Both Lemtrada and Gilyena can cause easy bruising. Lemtrada can cause an autoimmune response where the platelets are destroyed which in turn results in bleeding tendency like easy bruising. Gilyena can affect the functioning of liver .Liver produces coagulation factors which are needed for adequate blood clotting. Deficiency of coagulation factors seen in liver dysfunction can also cause easy bruising.
I see that you have already undergone blood tests.But since you are on these medications, I would recommend getting blood counts, coagulation factor levels, Liver function test redone in order to make sure that side effects of medication is not the contributing factor for easy bruising.

Easy bruising could also be due to conditions causing skin thinning like scurvy(nutritional deficiency of vitamin C) ,Cushings syndrome( characterized by increased corticosteroid levels in body), Topical steroid use etc.

Please be advised to follow up with your primary care provider to get the necessary investigations done and evaluation of any other disorders causing easy bruising.

Hope I was able to help you
Please address further questions here
Regards
Dr.Lekshmi
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Lekshmi Rita Venugopal (3 days later)
Thank you for answering my question. So once the Lemtrada is out of my system, should the platelets and if any deficiencies are in the coagulation build back up automatically?
doctor
Answered by Dr. Lekshmi Rita Venugopal (9 minutes later)
Brief Answer:
Follow up answer

Detailed Answer:
Hello again,

Treatment for Thrombocytopenia (decreased platelets) due to Lemtrada depends on the severity of the issue. Since you are experiencing only minimal bruising, just discontinuing the medication will normalize your platelet level and blood coagulation.

However, in severe cases with increased bleeding, bleeding into internal organs etc treatment with corticosteroids, IV immunoglobulins, plasma exchange and platelet transfusion will be needed.

Hope I was able to help you
Please address further questions here
Regards
Dr.Lekshmi
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Lekshmi Rita Venugopal

General & Family Physician

Practicing since :2012

Answered : 3808 Questions

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What Causes Easy Bruising While On Lemtrada And Gilenya?

Brief Answer: Causes of easy bruising Detailed Answer: Hello, Thank you for the query at HealthcareMagic I have gone through your query and seen the reports attached. Both Lemtrada and Gilyena can cause easy bruising. Lemtrada can cause an autoimmune response where the platelets are destroyed which in turn results in bleeding tendency like easy bruising. Gilyena can affect the functioning of liver .Liver produces coagulation factors which are needed for adequate blood clotting. Deficiency of coagulation factors seen in liver dysfunction can also cause easy bruising. I see that you have already undergone blood tests.But since you are on these medications, I would recommend getting blood counts, coagulation factor levels, Liver function test redone in order to make sure that side effects of medication is not the contributing factor for easy bruising. Easy bruising could also be due to conditions causing skin thinning like scurvy(nutritional deficiency of vitamin C) ,Cushings syndrome( characterized by increased corticosteroid levels in body), Topical steroid use etc. Please be advised to follow up with your primary care provider to get the necessary investigations done and evaluation of any other disorders causing easy bruising. Hope I was able to help you Please address further questions here Regards Dr.Lekshmi