Doctors Lounge - Hematology Answers
provided on www.doctorslounge.com is designed to support, not
replace, the relationship that exists between a patient/site
visitor and his/her physician."
Back to Hematology Answers List
- Thu Dec 15, 2005 6:36 pm
Hello, I have had a consistently low platelet count on my CBC for the past 8 years, my doctors do not know what to do about it and it has been declining. I started with 100 and it is now averaging around 70 and has dropped as low as 53. Normal limits being above 150 to 400+, I am a bit concerned that not only are my physicians stumped, they aren't doing anything to resolve it either.
What could cause this and what tests would need to be done to document it?
Thank you for your time.
| Dr. Tamer Fouad
- Sat Jan 28, 2006 11:45 am
The presence of persistant thrombocytopenia in the range you have described will require a bone marrow biopsy to reach a diagnosis.
Generally speaking thrombocytopenia can be due to defective production in the bone marrow or due to rapid destruction (usually by immune destruction).
Diagnosis of a platelet production defect is readily established by examination of a bone marrow aspirate and biopsy.
The finding of a reduction in the total cellularity of the marrow, along with a decrease in megakaryocytes, implies aplastic or hypoplastic anemia. This may result from drug toxicity.
A marrow that is fibrosed or infiltrated with leukemic or other malignant cells represents the syndrome of pancytopenia from infiltrated marrow.
After excluding diseases of the bone marrow the clinician should exclude the possibility of hypersplenism.
Certain non-immunologic causes of rapid platelet destruction include disseminated intavascular coagulation, preeclampsia, vasculitis, thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome among other things.
Finally immunological destruction of platelets as occurs in conditions such as Idiopathic thrombocytopenia purpura (ITP) should be excluded.