A 34-Year-Old Man Is Evaluated in the Clinic Due to Easy

A 34-year-old man is evaluated in the clinic due to easy bruising.  The patient says that even minor trauma causes a bruise and that he sometimes has spontaneous bruising over his legs.  He has also been experiencing generalized fatigue, poor appetite, and dull pain and stiffness in his lower back and joints at night.  The patient has a history of Crohn disease that required a partial bowel resection a year ago.  Three months ago, he was treated with oral antibiotics for a perianal fistula.  His mother died of colon cancer when she was 56.  Physical examination shows several large ecchymoses on his lower extremities.  Which of the following is the most likely diagnosis?

A) Autoimmune hepatitis
B) Bile acid malabsorption
C) Factor VIII deficiency
D) Immune thrombocytopenic purpura
E) Leukocytoclastic vasculitis

Correct Answer:

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