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Hello nad thank you for your question
How long has she had this discoloration?
where on the body i it located?
for about 5 days now
arms, legs, trunk, hands, feet
it's a pale bluish color along with the red patches that look similar to a burise
her blood-oxygen levels are normal and there no abnormalities noted in any of the testing
please be patient I am trying to read your information.
did she have a blood count done?
was the platelet count normal?
there was an error in next-to-last line...it should have read NO blood-related abnormalities
is her platelt count normal?
the bruises can be caused by the low platelet count.
also liver function--is that normal?
and any anemia?
her liver function is normal
now do the rash blanch on putting pressure?
no signs of anemia
i dont know about the blanching
likely turning white on putting thumb pressure on the rash?
i dont know
also, are they painful?
yes. she complains of pain in her left arm, some numbness in the left arm and shortness of breath
see these symptoms can be due to the vasculitis.
Vasculitis refers to the inflammation of the blood vessels.
This is an autoimmune condition.
The blood tests may be normal initially.
However, inflammatory markers like sed rate, CRP, ANA titer, ANCAs may be elevated
So, these are specialized tests that should be checked.
Did she have any chest xray, ekg and echocardiogram?
these tests are required to rule out any underlying lung and heart condition.
vasculitis can affect these organs as well.
she had a chest x-ray...results were normal
EKg and echocardiogram also should be considered.
Another possibility can be pulmonary embolism --blood clot in the lung blood vessels.
This is best seen in the CT angiogram.
she was checked for a blood clot and none was found
I guess d dimer --a blood test.
In that cardiac tests are essential.
And the work up for vasculitis.
are there any other possibilities?
Yes there are other psosibilities --less common
like pericarditis or inflammation of the heart memmbrane
could you tell me what they are?
Myocarditis -- inflammation of heart muscls.
These are more likely.
i suppose a trip back to the ER is in order
I recommend you to consult with a specialist --like a dermatologist and a cardiologist for better work up.
At least the above tests should be ordered.
thank you doctor
A skin biopsy also should be considered which often provides best diagnosis for vasculitis.
The vasculitis also can affect the brain by the way.
And that can be one of the reasons for learning disabilities.
So, this is an important work up from that point of view.
yes it certainly sounds that way
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i will do that
and thank you
All the best