News  |  Journals  |  Conferences  |  Blogs  |  Articles  |  Forums  |  Twitter   
 

 Headlines:

 
 

Doctors Lounge - Hematology Answers

"The information 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

Forum Name: Hematology Topics

Question: Unsteady platelet count


 sathish57 - Mon Feb 05, 2007 7:23 am

Hello dr,
My cousin is now 21 yrs old, female for whom the platelet count is not all constant. It was 1.15lakh in 2002 and keeps on varying low down to even 3000. Now it is again 77000 and doctors were not able to diagonise even after all the results including the bone marrow test. She has a scar in the right part of her nose and one more seems to come soon on the left part too. In 2002, she was very week and was given 8 units of platelets. Now what is wrong & what is deficient with her dr? What should we do to make her alright? She s physically good, but sometimes become tired. I have her complete report of all these years but if you want to take a look at it, how do I send it to you dr?

Thank you in advance.
 Dr. Safaa Mahmoud - Mon Feb 05, 2007 12:42 pm

User avatar Hello,

Causes of thrombocytopenia are classified into 3 main types according to where the problem is, these type are:

-Sequestration problem: due to spelenomegally which causes platelet destruction and shorter life span.

- Decreased production: due to BM problems like MDS, infiltration by leukemic cells in which other element of blood components may be affected, selective impairment in platelet production occur also due to bone marrow defects.

-Increased destruction: Immune or non immune destruction.

Idiopathic autoimmune platelet destruction ITP is the commonest cause of isolated thrombocytopenia in young females, the diagnosis is usually done by exclusion of other causes.

Lab results in most of the cases show:
-isolated thrombocytopenia
-increased MPV
-normal PT, PTT

You can send provide us with the list of the investigations done and the results of the last one.

What kind of treatment is being offered for her, and is there any other family history of similar condition?

Keep us updated.
Best regards
 sathish57 - Tue Feb 06, 2007 12:45 am

Thank you Dr. Safaa Mahmoud for your valuable time. I am updating you with the complete details of the patient. Kindly tell what exactly the problem is and how can it be over come?

BIOCHEM REFERENCE RANGES:

NAME:xxxxxxx AGE:16 SEX:F

11-04-2002:
Bone marrow
Unsatisfactory for evaluated suggest repeat
Biopsy 6469/02 URG
Bone marrow
LDH 325 U/L
CBC profile:
BF-3, Poly-57, Eosin 1, Baso 1, Lymph 31, mono 7, Aniso+Burr cell prt
MCV 36.6 f1
MCH 29.7PG
MCHC 34.3 G/DL
RDW 14.1%
TOTAL WBC 5500/CC MM
HB - 10.2 GM/DL
PLATELET COUNT - 5000 ccmm
Creatinine 0.8mg%
Reticulocyte count 0.7%

13-04-2002
Lead blood-13 ug%

15-04-2002
Biopsy 6724/02URG
Scanty norms to midly hypocellular marrow with adequate numbers megakaryocytes, trephine biopsy
0811 socrates mathew & sheila.

BONE MARROW URGENT
Impression: Cellular marrow with iron deficiency & adequate m consistent with peripheral platelet destruction

16-04-2002
BONE MARROW REPORT
Cellularity of fragments: Normo cellular. Adequate mega karyocyte
Smears : Normo cellular
DC count on 200 cells
Erythroid precursors - 22.5%
Myeloblasts - 0%
Promyelocytes & myelocytes - 16%
Metamyelocytes & Bandforms - 36%
Neutrophils - 18.5%
Eosinophils & precursors - 2.0%
Lymphocytes - 5.0%
Plasma cells - 0%
Erythriod maturation & morphology - Normoblastic erythroid
maturation with mild delay in haemoglobinisation
Myeloid maturation & morphology - All stages seen
Lymphoid cells - Normal
Plasma cells - Normal
Megakaryocytes - Adequate in number. No platelet budding seen
Other cells - No abnormal cells or parasites
Special strains - Iron : Absent iron stores
Impression - Cellular marrow with iron deficiency & adequate megakaryocyte.
Consistent with peripheral platelet destruction

06-05-2002:
MEAN CORPUSCULAR VOLUME 90.7 RBC
WBC DIFFERENTIAL
Neutrophils- 64%
Lymphocytes- 33%
Monocytes- 3%
WBC total- 11100/cu mm
Platelet count- 130000 cc mm
Haemoglobin - 11.7gm%

04-07-2002
WBC DIFFERENTIAL
BAND FORMS 16%
Neutrophils- 44%
Lymphocytes- 37%
Monocytes- 2%
Eosinophils- 1%
WBC total- 5600/cu mm
Platelet count- 2,25,000 cc mm
Haemoglobin - 13.5gm%

03-10-2002
WBC DIFFERENTIAL
TOTAL WBC 4200/ CC MM
PLATELET COUNT 142000 CC MM
HAEMOGLOBIN 12.6GM%

26-12-2002
CBC PROFILE
DC:NE:35% EO:05% B.Pic
MCV 88.7 f1
MCH 31.1 PG
MCHC 35.1 G/DL
RDW 11.9%
TOTAL WBC 5200/CU MM
HB 13.1 GM/DL
PLATELET COUNT 56000 CC MM
relapse of ITP

15-05-2003
CBC Profile
DC:NE:49 EO:02 Ba:01 MO:06 LY:42 B.Pic+ovalocytes present. On smear platelet count is 30,000/ccmm
MCV 89 f1
MCH 31.2 PG
MCHC 35.0 G/DL
RDW 12.9%
TOTAL WBC 6400/CU MM
HB 12.4 GM/DL
PLATELET COUNT 25000 CC MM

06-06-2003
WBC DIFFERENTIAL
BAND FORMS 04%
Neutrophils- 36%
Lymphocytes- 56%
Monocytes- 4%

16-06-2003
WBC total 3700/cc mm
Platelet count 345000 cc mm
Reticulocyte count 1.2%
Haemoglobin 10.7gm%

01-09-2003
WBC DIFFERENTIAL
BAND FORMS 05%
Neutrophils- 45%
Lymphocytes- 51%
Monocytes- 1%
Eosinophils- 03%
WBC total- 6600/cu mm
Platelet count- 58000 cc mm
Haemoglobin - 12.6gm%

29-12-2003
WBC DIFFERENTIAL
BAND FORMS 05%
Neutrophils- 49%
Lymphocytes- 38%
Monocytes- 3%
Eosinophils- 05%
WBC total- 4500/cu mm
Platelet count- 9000 cc mm
Reticulocyte count 1.5%
Haemoglobin - 12.4gm%

Age-18

05-02-2004
WBC DIFFERENTIAL
Neutrophils- 54%
Lymphocytes- 38%
Monocytes- 2%
Eosinophils- 07%
Basophils- 01%
WBC total- 4600/cu mm
Platelet count- 1,44,000 cc mm
Haemoglobin - 13gm%

07-02-2004
Ana AF786
Positive (speckled) suggest sample for DS DNA and U1RNP ELISA

27-04-2004
WBC DIFFERENTIAL
toxic granules prt
Neutrophils- 77%
Basophils - 01%
Lymphocytes- 18%
Monocytes- 1%
Eosinophils- 03%
WBC total- 4800/cu mm
Platelet count- 58000 cc mm
Haemoglobin - 12.6gm%
toxic granules prt
Platelet count - 49000 cc mm
Haemoglobin - 12.9 GM%

16-06-2004
URINALYSIS ROUTINE
Mucus ++ Ca.oxalate cry yeast cells PRT
Glucose - Negative Bilirubin - Negative
Ketone - Negative Speci.gravity- 1.025
Blood - Negative PH - 6.0
Protein - trace Urobilinogen - 1.0
Nitrite - Negative Leukocytes - trace
RBC - 2 - 4 WBC - 4-6

WBC DIFFERENTIAL
BAND FORMS 01%
Neutrophils- 58%
Lymphocytes- 33%
Monocytes- 3%
Eosinophils- 05%
WBC total- 4400/cu mm
Platelet count- 74000 cc mm
Haemoglobin - 12.8gm%

LFT
Bilirubin total - 0.9mg% direct - 0.3mg%
Protein total - 6.9% Albumin - 4.5gm%
SGOT - 22 U/L SGPT - 11 U/L
ALK PHOS - 70 U/L

Serum complement CL887
CH 70% C3C
C4

DS DNA Estimation (ELISA) DS1269
Anti DS DNA antibody level within normal limits

Age 19
17-02-2005
WBC DIFFERENTIAL
Neutrophils- 65%
Lymphocytes- 29%
Monocytes- 3%
Eosinophils- 03%
WBC total- 4700/cu mm
Platelet count- 40000 cc mm
Haemoglobin - 12.4gm%
plt on smear - 75000
glant plt prt

30-06-2005
CBC Profile
DC:Bn:05 EO:06 NE:62 LY:25 B.Pic normo chromic normo cytic
MCV 93.3 f1
MCH 31.9 PG
MCHC 34.2 G/DL
RDW 11.9%
TOTAL WBC 4900/CU MM
HB 12.7 GM/DL
PLATELET COUNT 34000 CC MM
RBC 3.97
HCT(PCV) 37.1

Age 21
28-01-2007 (will update with other details too)
Platelet count - 77000 cc mm

Doctors were nt able to diagonise anything from the report doctor. So please kindly help me.

Once again Thank you a lot in advance doctor.

|

Check a doctor's response to similar questions

 

advertisement.gif (61x7 -- 0 bytes)
 

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

 
     

 advertisement.gif (61x7 -- 0 bytes)

 

 

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us

 
Copyright © 2001-2010
Doctors Lounge.
All rights reserved.

Medical Reference:
Diseases | Symptoms
Drugs | Labs | Procedures
Software | Tutorials

Advertising
Links | Humor
Forum Archive
CME Articles

Privacy Statement
Terms & Conditions
Editorial Board
About us | Email

We subscribe to the HONcode principles of the HON Foundation. Click to verify.We subscribe to the HONcode principles.
Verify here