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What Causes Low Platelet Count?

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Posted on Wed, 17 Sep 2014
Question: I have lower blood platelets count of 130 and my MPV is higher-13.8 my other cbc and diff results are normal and same as all the metabolic panel results. All is within range
I had in the past low plateles too- once 127 another time 135. Never lower than that but then i also had above 150 in other years. I am seeing a hematologist in 2 weeks but is this that sounds bad?
doctor
Answered by Dr. Shoaib Khan (12 minutes later)
Brief Answer:
Need to rule out a few conditions

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. As you have had a history of fluctuating platelet count, there are a few conditions that should be ruled out and a hematologist should be consulted.

As your platelet count has not dropped too low, it is not really a serious cause for concern but a few conditions like listed below will have to be ruled out:

-Infection like hepatitis C, Epstein-Barr, mononucleosis, HIV, etc. (depending on history and a full body check up)
-Bone marrow abnormalities (eg. apalstic anemia, etc.)
-Cancer (rare and unlikely as your platelet count is not too low, but it still better to test and rule it out ma'am)
-Untreated or inappropriately managed bacterial infection in your blood
-Recurrent viral infections like dengue, etc. (depending on locality of inhabitance)
and a few others.

A consultation with a hematologist will surely help guide you towards finding the cause for your low and fluctuating platelet count ma'am.

I hope you find my response helpful. I would be more than happy to be of further assistance to you.

Best wishes ma'am.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (2 days later)
I see. So my MPV ia higher too on top of low platelet count so bone marrow is making the platelets , hence the high MPv. So how could it be aplastic anemia.
Also, the other cbc pareters and differential is good. Nothing bad so rules out cancer as per fhe hematologist.
He checked spleen is not enlarged.
Hiv, hep b and hep c was checked in 2012 and was all negative. Yet in 2008 and 2004 my platelet count was low so hep b hep c or hiv is not causing it.
I saw hematolugist he said that all it means is that i am that 5 percent of population that falls below the reference range. He said that no further tests are required.he checked spleen and was not enlarged he could not feel it at palpation.
doctor
Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer:
Quite possible; few more causes from experience

Detailed Answer:
Hello once again XXXXXXX

It was a good idea to visit your haematologist who has provided quite an insight on the mild thrombocytopenia you are experiencing. There are a few other causes I have also seen in my experience that can cause mild thrombocytopenia, but these are all very mildly contributing. I shall list these out for you as well, just in case you decide to go over them with your doctor once again. They are:
-Vitamin B12 deficiency
-Folic acid deficiency
-Alcohol abuse (not small amounts, but a chronic alcoholic)
-Use of certain medications (whether a short or long duration of time)
-Certain infections like tuberculosis (which is commonly seen in XXXXXXX where I used to practice)
-Occupational hazzard to individuals (eg. engineers, doctors, technicians, etc.) who are exposed to radiation
-I also noticed a drop in platelet count in patients immediately after chemotherapy or radiotherapy

I have just listed other causes from my practice, which I would like to pass on to you as you are mainly here for guidance and information. Of course, what your haematologist has suggested is quite possible, and you could belong to that 5 %, but before making such an assumption I would like to rule out all causes, which I am sure he has done.

You should also know that individuals belonging to this population are advised routine check-ups (annual). I would also like you to try a diet that can promote the production of platelet production (Eg. prunes; fish-tuna, salmon; eggs; flax seeds; initiate a good multivitamin and mineral supplement; adequate sleep and exercise; etc.).

I hope you find my response helpful and I wish you nothing but luck. Please do not hesitate to write back to me for any further clarifications, I would be more than happy to help you.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (18 minutes later)
He didnt go that extensively into all this things. He said that it is such an insignificant drop. He is the chief pf bone marrow transplants here at the hospital i work . He said that no further testing is needed. Just watching if it goes lower or if it stays here than is all good
doctor
Answered by Dr. Shoaib Khan (3 minutes later)
Brief Answer:
Your doctor knows best!!

Detailed Answer:
Hello once again XXXXXXX

I am sure he is much more experienced than me, and being the chief of bone marrow transplants I am sure he knows better than what most of us do on such a topic.

Let us keep an eye on your platelet count, but what you can do the next time is request him to check your serum vitamin levels, saying that it is something you wish to do for your interest. If all returns normal, we shall stop pondering over this.

It is not that we need to find a cause to make us feel better, we would just like to know that there is no cause. I hope you understand why I have suggested this, I most certainly do not doubt your doctors credibility, he must be more than great.

Please feel free to keep in touch with me or write to me to give me the good news that all is well.

Best of luck and God bless.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (2 minutes later)
So what should i then get tested in blood for? Please list here and i wkll ask my family doc
doctor
Answered by Dr. Shoaib Khan (13 minutes later)
Brief Answer:
Listed ma'am

Detailed Answer:
Hi XXXXXXX

-Serum vitamin B12
-Serum folic acid
-Vitamin A
-Vitamin B6
-Vitamin B1

Once the results are in and your family doctor has ruled out any abnormalities, you can rest assured that there is no other cause to your platelet fluctuation.

I hope this helps. Please do not hesitate to write back to me for any further assistance, I am always here to help.

Best wishes.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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What Causes Low Platelet Count?

Brief Answer: Need to rule out a few conditions Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. As you have had a history of fluctuating platelet count, there are a few conditions that should be ruled out and a hematologist should be consulted. As your platelet count has not dropped too low, it is not really a serious cause for concern but a few conditions like listed below will have to be ruled out: -Infection like hepatitis C, Epstein-Barr, mononucleosis, HIV, etc. (depending on history and a full body check up) -Bone marrow abnormalities (eg. apalstic anemia, etc.) -Cancer (rare and unlikely as your platelet count is not too low, but it still better to test and rule it out ma'am) -Untreated or inappropriately managed bacterial infection in your blood -Recurrent viral infections like dengue, etc. (depending on locality of inhabitance) and a few others. A consultation with a hematologist will surely help guide you towards finding the cause for your low and fluctuating platelet count ma'am. I hope you find my response helpful. I would be more than happy to be of further assistance to you. Best wishes ma'am.