Differential Diagnosis for Easily Bruising without Injury

The following differential diagnosis is organized into categories to help guide the thought process:

• Single Most Likely Diagnosis
  • Vitamin C Deficiency (Scurvy): A common cause of easy bruising due to the essential role of vitamin C in collagen synthesis and blood vessel integrity. A diet lacking in vitamin C can lead to scurvy, characterized by bruising, fatigue, and malaise.
• Other Likely Diagnoses
  • Vitamin K Deficiency: Important for blood clotting, a deficiency can lead to easy bruising and bleeding. This is more common in individuals with malabsorption or those taking anticoagulant medications.
  • Platelet Disorders (Thrombocytopenia or Platelet Dysfunction): Conditions affecting the number or function of platelets can lead to easy bruising due to impaired blood clotting.
  • Medication Side Effects (e.g., Anticoagulants, Steroids): Certain medications can increase the risk of bruising by affecting blood clotting or blood vessel integrity.
• Do Not Miss Diagnoses
  • Leukemia: A type of blood cancer that can cause easy bruising due to bone marrow failure leading to a decrease in platelets and other blood cells. Early detection is crucial for effective treatment.
  • Liver Disease (Cirrhosis): The liver plays a critical role in producing clotting factors. Liver disease can lead to coagulopathy, resulting in easy bruising and bleeding.
  • Bleeding Disorders (e.g., Hemophilia, von Willebrand Disease): Genetic disorders that affect blood clotting, leading to easy bruising and bleeding. These conditions require specific management to prevent serious complications.
• Rare Diagnoses
  • Ehlers-Danlos Syndrome: A group of genetic disorders affecting connective tissue, which can lead to easy bruising due to fragile blood vessels and poor wound healing.
  • Amyloidosis: A condition characterized by the deposition of abnormal proteins (amyloid) in various tissues, including blood vessels, which can lead to easy bruising and bleeding.
  • Scurvy due to other causes (e.g., malabsorption, certain medications): While vitamin C deficiency is the most common cause of scurvy, other factors can also lead to this condition, resulting in easy bruising among other symptoms.

Each of these diagnoses has a distinct pathophysiology that contributes to the presentation of easy bruising without injury, emphasizing the importance of a thorough diagnostic approach to identify the underlying cause.