What Causes Severe Bruising After Taking Heparin Injection?

Posted on Fri, 17 Mar 2017

Question: I am a free bleeder and was given Heperin at least once in an IV, since I've experienced, many skin problems, the slightest bump causes skin tears and prolonged bleeding, bruising as well as dk. red under skin marks. I've always bruised easily ( I am Blonde blue eyed, and of a scandinavian father) BUT not like this, itdoes not seem to improve. PS I am a nurse.
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Answered by Dr. Shoaib Khan (1 hour later)

Brief Answer:
I suggest a diagnosis to be established and then treatment initiation

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. I can understand how frustrating and at the same time restricting your presentation can be. But I would also like to emphasize the importance of a diagnosis. There are a few conditions that can cause such a presentation, and at least if we can find out the cause accurately, we can direct treatment instead of just blindly treating you just for the easy bleeding.

Let me list down a few of the most likely causes for your reference, and discussion with your doctor during the next visit, they are:

+Hemophilia
+Thrombocytopenia
+Lupus
+Sickle cell disease
+Liver abnormalities (e.g. cirrhosis of the liver)
+Nutritional deficiencies (E.g. vitamin C)
+Myelodysplastic syndrome
+Blood coagulation factor disorders: Von Willebrand Disease (more common in women)

As you may have understood ma'am, each of these conditions has a different target organ/source, and so just treating their common symptoms (easily bleeding and/or bruising) will not solve the issue.

I would thus recommend you to visit your doctor again (pref. a Hematologist) and get elaborately evaluated, so we can find the source, understand why it is more aggravated now than before, and initiate a more accurate form of treatment.

I hope you find my response helpful and informative. Please feel free to write back to me for any further clarifications, I am always here to help.

Best wishes.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Shoaib Khan (45 minutes later)

I have always bled easily, and bruised easily, but not had a superficial cut bleed for four days, I was in hospital and caught a nurse putting something in IV, she said, in broken English, that is was "To prevent blood clots" told her NO, I am a free bleeder, later tried to give me Coumadin orally, told her same again, ASA is listed under allergies for this reason. about 6 mos after that I fell and suffered a clean fx to lt. hip as well as one to pelvis and a collies to wrist, I was given Demerol in IV for pain and discharged with oral pain meds, about 3 weeks trying to find an Ortho that spec in wrist and hand (long story) I had surgery to repair hand damaged by ER doc and wrist, when he went to put bones in proper pos. for pinning, the skin on my arm came off in his hand, so there is a possibility I was given Heperin again during the 3 days I was in hospital, I just now would like to get back to where I don't bleed just touching up against a cabinet, bucket, what ever. I eat dk. green veggies and I am an active person, have no problems from hip or pelvis, just having skin open up if touched wrong.

Answered by Dr. Shoaib Khan (19 minutes later)

Brief Answer:
Please consider discussing the use of clotting factors to manage your case

Detailed Answer:
Hello once again ma'am.

Thank you for that information.

In my opinion, if you were my patient, I would concentrate on providing you with replacement therapy which entails the use of clotting factor 8, 9 or 11.

These clotting factors help to replace any absent factor that may be causing the frequent bleeding, and prevent it completely (i.e. as long as the treatment is continued).

I do think heparin would have been administered to prevent the formation of a clot, which is mandatory after orthopedic surgeries (as it can result in serious life-threatening conditions if not administered).

The effect of the heparin should also wear out soon, but I would recommend speaking to your prescribing doctor about the use of clotting factors to help you to deal with a more comfortable normal life.

Please keep me in the loop, and in the meantime do not hesitate to write to me about anything.

Best wishes.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Shoaib Khan (5 minutes later)

Thanks, I'll ask her when I go for next visit.

Answered by Dr. Shoaib Khan (3 minutes later)

Brief Answer:
My pleasure entirely

Detailed Answer:
You are most welcome ma'am.

Best of luck.

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Arnab Banerjee