Differential Diagnosis for Easy Bruising in a 26-year-old Female
Single Most Likely Diagnosis
- Vitamin deficiency (specifically Vitamin C or K deficiency, in addition to her known Vitamin D deficiency): Given her history of vitamin D deficiency, it's plausible she might have deficiencies in other vitamins, which could contribute to easy bruising. Vitamin C is crucial for collagen synthesis, and its deficiency can lead to poor wound healing and easy bruising. Vitamin K is essential for blood clotting.
Other Likely Diagnoses
- Thrombocytopenia: This condition, characterized by low platelet count, can lead to easy bruising. It could be related to her THC dependence or other underlying conditions not yet identified.
- Liver disease: Although she denies alcohol use, liver disease can lead to coagulopathy and easy bruising due to decreased production of clotting factors. Her THC dependence might be a risk factor for liver disease.
- Hormonal influences: Hormonal fluctuations can affect blood vessels and lead to easy bruising. Given her age and gender, this could be a contributing factor, especially if she is experiencing significant hormonal changes.
Do Not Miss Diagnoses
- Leukemia or lymphoma: These conditions can cause easy bruising due to bone marrow suppression leading to thrombocytopenia or platelet dysfunction. Although less common, missing these diagnoses could be fatal.
- Immune thrombocytopenic purpura (ITP): An autoimmune condition that results in low platelet count, which could present with easy bruising as a primary symptom.
- Von Willebrand disease: A genetic disorder that affects blood clotting, which could be missed due to the lack of family history but should be considered due to its potential severity.
Rare Diagnoses
- Ehlers-Danlos syndrome: A group of genetic disorders that affect connective tissues, which could lead to easy bruising due to fragile blood vessels.
- Scurvy (Vitamin C deficiency): Although rare in developed countries, scurvy can cause easy bruising, and given her history of vitamin deficiency, it's worth considering.
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, which can lead to easy bruising due to vascular fragility. It's rare but should be considered in the differential due to its severity.