Bruising And Fatigue Could Signal Blood Disorder

KUALA LUMPUR, April 15 (Bernama) -- The majority of people will brush off unexplained bruises and fatigue or fever as being stressed or not having enough sleep or maybe a virus that will go away on its own.

However, according to Sunway Medical Centre (SMC) Consultant Clinical & Laboratory Haematologist Dr Andy Tang Sing Ong, these subtle signs can mean that we have an underlying blood disorder and early testing can make all the difference.

“One of the biggest challenges in diagnosing blood disorders is that early symptoms are easy to dismiss.

“People assume bruising is due to minor knocks, or fatigue is due to lack of sleep, but we look at patterns,” Dr Andy said in a statement today.

Red flag symptoms that should prompt medical attention include persistent or unexplained fever lasting more than two to three weeks, unusual bruising in areas not typically prone to injury, such as the back or abdomen and unexplained gum bleeding.

Frequent infections without clear exposure to sick contacts, night sweats, unintentional weight loss or loss of appetite as well as painless lumps or enlarged lymph nodes that do not go away are also symptoms that should not be ignored.

“Painless lumps are actually more concerning than painful ones. Painful lumps are often due to infection. Cancerous lumps are usually painless. For parents, recurrent infections in children especially those requiring repeated hospitalisations should also raise concern,” he added.

Dr Andy also explained that one of the most common blood cancers is leukaemia, which occurs when mutations in the DNA of blood-forming cells cause them to multiply uncontrollably, with acute types which progress rapidly and chronic types, that develop more slowly.

“Most leukaemia cases are due to acquired mutations that happen after birth. They are not usually inherited. However, if there is a strong family history of multiple cancers across generations, genetic evaluation may be considered,” he said.

On the other hand, non-cancerous blood disorders often involve problems with bleeding or abnormal clotting. These may be inherited, such as haemophilia, or acquired later in life. Others, like immune thrombocytopenia (ITP), occur when the immune system mistakenly attacks its own platelets.

He stressed that certain blood cancers are more common in specific age groups. Acute lymphoblastic leukaemia (ALL), for example, is more frequently seen in children, while other forms are more common in older adults.

He pointed out that environmental and medical risk factors may also play a role, including exposure to radiation, benzene, pesticides, or prolonged use of immune suppressing medications for autoimmune conditions such as lupus.

Women in their reproductive years are more prone to immune related blood disorders like ITP and autoimmune anaemia, Dr Andy said, adding that long-term use of oestrogen-containing oral contraceptive pills may increase the risk of blood clots in some women.

“Not everyone with risk factors will develop disease. But awareness helps with early detection. We start with a detailed history and physical examination. From there, we do basic blood tests. Not everyone needs extensive testing,” Dr Andy explains.

If abnormalities are found from blood test, such as unexplained low or high blood counts with no viral infection, more specialised tests or imaging will be recommended.

“A bone marrow biopsy or mutation test is only performed when necessary, such as when there is suspicion of cancer, unexplained persistent fever, or unclear causes of abnormal blood results,” he added.

According to Dr Andy, bone marrow examination helps to confirm whether there is cancer, infection or an autoimmune issue and guides the correct treatment.

He shared a common public misconception - all blood cancers require chemotherapy. Chemotherapy remains the backbone, and treatment is usually combined with targeted therapy, immunotherapy or stem cell transplantation in some cases.

For non-cancerous conditions, the treatment is different, with bleeding disorders requiring platelet transfusions or clotting factor replacement, blood clots are typically managed with blood-thinning medications, tailored to each patient’s needs and risk profile.

Autoimmune disorders often involve steroids or other immune-modulating therapies that are carefully and frequently monitored to minimise long-term side effects.

“For some higher risk leukaemia or relapsed lymphomas, stem cell or bone marrow transplantation may be considered. This can involve using own stem cells or cells from a donor,” Dr Andy said, as he emphasised the importance of seeking medical advice even with mild symptoms.

“Seeking medical advice for mild symptoms is never overreacting. Our body whispers and gives us signs that something is wrong before it gets worse.

“Never ignore if symptoms persist or worsen despite rest or basic treatment. Early intervention can detect problems at a stage where treatment is more effective and outcomes are better,”  he added.

-- BERNAMA 

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