How are recurrent bruises and easy bleeding diagnosed?

To diagnose the cause of recurrent bruising and easy bleeding, a doctor begins by gathering detailed information about the patient's medical and family history, in addition to the visible symptoms. This is followed by a thorough physical examination to look for signs of bleeding. Afterward, the doctor may order several blood tests, such as a complete blood count, blood smear, and in some cases, bone marrow tests, to identify the underlying problem.

Initial Examination and Medical History

When visiting a doctor for recurrent bruising or easy bleeding, the doctor will first take a detailed medical history. They will ask about when the bruising started, its frequency, and whether any prior injuries or accidents led to it. It is important to mention any medications being taken, including over-the-counter drugs like aspirin, or blood thinners such as warfarin or heparin, as these medications can contribute to easy bleeding [3]. The doctor will also ask about the family history of any bleeding disorders and any other conditions the patient may have, such as autoimmune diseases or viral or bacterial infections, which may be associated with low platelet counts [1].

Physical Examination and Blood Tests

After obtaining the medical history, the doctor will perform a comprehensive physical examination to look for signs of bleeding. These signs may include small, flat red spots under the skin called petechiae, bleeding under the skin appearing as red, purple, or yellowish-brown spots called purpura, or large, clotted bruises under the skin called hematomas [1].

Blood tests are an essential part of the diagnostic process. Among the most important are:

• Complete Blood Count (CBC): This test measures the number of platelets and other blood cells in the blood [1]. A low platelet count (thrombocytopenia) can be a primary cause of recurrent bruising and easy bleeding [3].
• Blood Smear: This involves placing a blood sample on a slide and examining it under a microscope to evaluate the shape and size of the platelets [1].
• Coagulation Tests: These tests measure how quickly blood clots and include prothrombin time (PT) and partial thromboplastin time (PTT) [3].

Additional Tests and Identifying Causes

In some cases, additional tests may be needed to determine the exact cause of recurrent bruising. For example, if initial blood test results are inconclusive or if there is a suspicion of a bone marrow issue, the doctor may order bone marrow tests (Arabic). These tests check whether the bone marrow is healthy and producing platelets correctly [1].

If the patient is at risk of HIV, Hepatitis C, H. pylori, or other autoimmune diseases, the doctor may request tests to screen for these infections, as they may be associated with conditions such as Immune Thrombocytopenia (ITP) [1]. It is important to note that recurrent bruising may not always be an indicator of a serious condition, but it is essential to consult a doctor to determine the cause and obtain the appropriate diagnosis and treatment [2].

Medical references

• Platelet Disorders Immune Thrombocytopenia (ITP)
• Bruises
• Bleeding into the skin