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What Causes Chronic Recurring Splinter Hemorrhages Under Fingernails?

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Posted on Sun, 20 Apr 2014
Twitter Sun, 20 Apr 2014 Answered on
Twitter Mon, 12 May 2014 Last reviewed on
Question : I am a 60 year old woman. I have chronic, recurring splinter hemorrhages under all of my fingernails. I have been seen by rheuma-. derma. and cardiologists. Blood work and cardiac tests do not indicate any disease. I have pretty severe osteoarthritis, mild psoriasis, hypothyroid, high bp (sometimes). I have a history of cataracts, endometriosis, gall bladder removal, carpal tunnel and trigger fingers. The accompanying fatigue and pain is what causes me to be concerned. But, I wonder if I have something systemic like vasculitis or lupus that has not appeared in the blood work. (I have had high and borderline high ANAs - but negative on the other antibodies.) I don't even know what kind of specialist to go to.
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Answered by Dr. Dr. Alokkalyani (43 minutes later)
Brief Answer: may be vasculitis Detailed Answer: Hi I m dr XXXXXXX pleased to answer your health related questions It seems that probably you have vasculitis, But I would like to know report of XXXXXXX APLA, pletelets level What about lung and kidney test? Dr XXXXXXX
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Dr. Alokkalyani (11 hours later)
don't know what XXXXXXX APLA platelets are but last blood work that was out of range showed: CCP antibodies 1 (0-19 units range); TSH 5.950 (.450-4.5/ml) Complement C4 - 38 (9-36mg/dl); CRP 2.04; ANA titer 1:160 (It has been as had as 3.60). I had lung x-ray when I had bronchitis, but only indicated the bronchitis. Have had chronic cough that comes at spells but is ot terrible or bothersome (I"m a non-smoker.) My Mom had MAI lung disease. No kidney function tests (I have had a kidney stone and surgery to remove it - with history of UTIs prior to removal.) Mom also had hashimoto's thyroiditis, sjogren's, and rheumatoid arthritis. sister has RA as well - so I have a history of autoimmune diseases. Should I ask for an XXXXXXX or APLA? IF it is vasculitis - is it a primary or secondary to something else? (I have worked in hospice for 10 years and picked up on some medical language - otherwise, I'm dumb about these things. :) Thanks for your response.
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Answered by Dr. Dr. Alokkalyani (18 hours later)
Brief Answer: Yes Detailed Answer: Hi, Based on the added information you provided, you should go for these investigation. Also, although not very clear in picture, but are you sure that this is not a super added fungal infection. You can check with a dermatologist as you explore further into vasculitis. If all the tests are normal than we have to search for the other cause of vasculitis. I can be able to assist you further once you have test results. Regards
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Above answer was peer-reviewed by : Dr. Prasad
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Dr. Dr. Alokkalyani

Rheumatologist

Practicing since :1999

Answered : 519 Questions

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What Causes Chronic Recurring Splinter Hemorrhages Under Fingernails?

Brief Answer: may be vasculitis Detailed Answer: Hi I m dr XXXXXXX pleased to answer your health related questions It seems that probably you have vasculitis, But I would like to know report of XXXXXXX APLA, pletelets level What about lung and kidney test? Dr XXXXXXX