[18F] With easy bruising, jaundice, and abdominal pain

Patient Description

An 18-year-old female presents with easy bruising on her legs for the past three days, with new bruises appearing daily. She also reports generalized itching, orange-colored urine, and slight yellowing of the eyes noticed yesterday. The patient experiences abdominal pain on the lower sides, particularly when breathing in. There is no history of recent injuries, medication changes, or significant dietary changes. She denies fatigue, changes in stool color, recent travel, or family history of liver disease or bleeding disorders. Her current medications include hyoscyamine 0.375 mg twice daily, birth control 1.5/30 mg once daily, and a daily probiotic. She recently took acetaminophen and ibuprofen for body aches without exceeding recommended doses. No known allergies except for penicillin, which causes a rash.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—easy bruising, orange urine, itching, slight yellowing of the eyes, and abdominal pain—there are a few possible explanations:

  1. Liver Dysfunction: The combination of yellowing of the eyes (jaundice), orange urine, and abdominal pain could suggest an issue with your liver. The liver is responsible for processing bilirubin, and when it's not functioning properly, bilirubin can build up, leading to jaundice and changes in urine color. Easy bruising can also occur if the liver is not producing enough clotting factors.

  2. Medication Effects: While you mentioned taking acetaminophen and ibuprofen within recommended doses, these medications can affect the liver, especially if taken frequently or in combination. It's important to consider this, especially if you have been using them regularly.

  3. Hematological Issues: Easy bruising can sometimes be related to blood or platelet disorders, which can also be associated with liver issues or other systemic conditions.

  4. Other Causes: There could be other causes for your symptoms, such as infections or autoimmune conditions, but these would require further evaluation by a healthcare professional.

What you can do

  1. Seek Medical Attention: It's important to consult a healthcare provider as soon as possible to evaluate your symptoms. They may recommend blood tests to check your liver function and other parameters.

  2. Monitor Symptoms: Keep track of any new symptoms or changes in your current symptoms. This information will be helpful for your healthcare provider.

  3. Avoid Alcohol and Certain Medications: Until you have more information, it might be wise to avoid alcohol and any unnecessary medications, especially those that can affect the liver.

  4. Use MDandMe: Consider using the MDandMe app to journal your symptoms, track any changes, and share this information with your healthcare provider. This can provide valuable insights into your condition.

What you should look out for

  • Worsening Symptoms: If you notice an increase in yellowing of the skin or eyes, worsening abdominal pain, or any new symptoms like confusion or severe fatigue, seek medical attention immediately.

  • Bleeding: If you experience any unusual bleeding, such as nosebleeds or blood in your stool or urine, this could be a sign of a more serious issue.

  • Severe Pain or Discomfort: Any severe or persistent pain should be evaluated by a healthcare professional.

Remember, while this information can help guide you, it's important to seek care from a real health professional to receive a formal diagnosis and appropriate treatment.

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1 mo ago

People Also Ask

What could cause easy bruising and yellowing of the eyes in a young adult?

Easy bruising and yellowing of the eyes, known as jaundice, can be caused by liver dysfunction. The liver may not be processing bilirubin properly, leading to its buildup in the body. Other potential causes include blood disorders or certain medications.

Can over-the-counter pain medications like acetaminophen and ibuprofen affect liver function?

Yes, acetaminophen and ibuprofen can affect liver function, especially if taken in high doses or frequently. It's important to use these medications as directed and consult a healthcare provider if you have concerns about liver health.

What are the signs of liver dysfunction that I should be aware of?

Signs of liver dysfunction include jaundice (yellowing of the skin and eyes), dark urine, pale stool, abdominal pain, itching, and easy bruising. Severe symptoms may include confusion, fatigue, and swelling in the legs or abdomen.

How can I differentiate between a liver issue and a blood disorder based on symptoms?

Liver issues often present with jaundice, dark urine, and abdominal pain, while blood disorders may primarily cause easy bruising and bleeding. Blood tests can help differentiate between the two by assessing liver function and blood cell counts.

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