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- Mon Jan 09, 2006 10:37 pm
I am a 37 year old female with no known health problems other than having high unexplained white blood cell counts at times. Over the last two months or so on three different occassions, I have had veins swell up in the palm of my hands and bulge. It doesn't happen anywhere else, but in my palms. I am not doing anything strenuous with my hands that would cause this. When it happens, I have a horrible burning sensation where the vein is bulging. After awhile, it will finally go down, but it stays very tender for the next few days and I always have a bruise to follow. This past Saturday it happened again, but this time my wrist is kinda sore.
Although I haven't had any veins bulging up anywhere else, I have had a lot of unexplained bruising on various other places. Could all this unexplained bruising be connected to these veins busting in my palms and what could possibly causing all of this?
| Dr. Tamer Fouad
- Tue Jan 31, 2006 4:30 pm
I really have no idea what the palm veins condition could be. I suggest that you show it to a doctor when it happens.
Regarding repeated bruising this should be investigated. Let me explain a few things about bruising and the normal body function of hemostasis (the mechanisms by which the body stops the bleeding process).
Hemostasis is usually broken down into two stages: primary and secondary. Primary hemostasis is an immediate (minutes) but unstable response to injury. The key participants are platelets (which form the platelet plug) and the blood vessels (which cause vasoconstriction). Secondary hemostasis, in contrast is a slower process (may take several hours) but results in a definitive fibrin clot (coagulation) that serves as the scaffold for vascular repair by the endothelium.
In disorders of platelet plug formation (primary hemostasis) the site of bleeding is usually superficial such as in the skin, mucous membranes (gingivae, nares, genitourinary tract). Petechiae are present and ecchymoses is usually small, superficial. Hemarthroses, muscle hematomas are rare in such cases. However, bleeding after minor cuts is more common than those with defective coagulation. Bleeding after surgery is usually immediate and mild in those with primary hemostasis abnormalities.
Lab tests used to evaluate primary hemostasis include a complete blood count (CBC) with platelet count. Bleeding time when prolonged in the presence of a normal platelet count and the absence of aspirin (or other NSAID) intake may suggest a platelet function abnormality or a von Willebrand's factor (vWF) deficiency.
Henoch-Schonlein, or anaphylactoid, purpura is a distinct, self-limited type of vasculitis that occurs in children and young adults. Patients develop a purpuric or urticarial rash on the extensor surfaces of the arms and legs and on the buttocks as well as polyarthralgias or arthritis, colicky abdominal pain, and hematuria from focal glomerulonephritis. Despite the hemorrhagic features, all coagulation tests are normal.
I think your repeated bruising would be the more pressing issue. I urge you to consult your doctor as soon as possible to determine a cause.