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Forum Name: Hematology Topics

Question: Bone marrow biopsy


 syntax - Mon Jul 09, 2007 12:50 pm

Hello,

25 year old male / thalassemia minima & chronic fatigue syndrome due to prior EBV infection.

Originally went in to my PCP back in May for a routine checkup and they found a low platelet count from my CBC. After a battery of tests, the hematologist diagnosed me with the thalassemia minima (rare considering I'm caucasian) and the CFS from the Epstein-Barr. The routine follow-ups have shown that my platelets continue to drop, but not rapidly, yet all other counts are normal. Initial count of 132, second count of 129 a month later, and most recently I'm at 126.

The hematologist suggested that I get a bone marrow examination (aspiration + biopsy) and an ultrasound of the abdomen to see if my spleen is enlarged.

What is bothering me is that before my last CBC I had been taking EES before & after a wisdom tooth extraction. Would this contribute to a drop in platelets? Also, since I've been diagnosed with CFS from the EBV, would that cause my platelets to flucuate?

I'm extremely nervous about the bone marrow examination and thinking that it may be a little premature, since all of my other counts are normal. I can understand the ultrasound, because of the possibility of an elarged spleen (which is not palapable).

Can anyone offer any advice/suggestions? Does this seem normal? Should I get a 2nd opinion?

Thanks,
M
 Dr. Chan Lowe - Tue Jul 10, 2007 11:06 pm

User avatar I'm not a hematologist so keep in mind that my advice comes as a general physician. Your platelet counts are borderline low. Really, there is no difference between 130, 129 and 126. Given the small amount of lab I would interpret this as your platelet count being unchanged.

However, your counts really aren't normal. I think a work up is appropriate. The EES is generally not reported to cause low platelets.

You may want to first start with the ultrasound before the bone marrow biopsy. If the ultrasound shows an enlarged spleen, the biopsy may not be necessary.

It is less likely but you may also want to be tested for auto-platelet antibodies (antibodies that attack the platelets).

Continued follow up with your hematologist is important. If you have any other cell lines that are not normal (anemia or low white blood cells) I would most definitely recommend doing the bone marrow biopsy.

Best wishes.

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