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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Decreasing Of Platelet Count From 160000 To 80000?

My platelet count is 80,000 and has decreased from 160,000 in the past year. Hemotologist just wants to monitor every two months. I had a bone barrow test one year ago. No findings although he said he did not get a good sample. Did not want to repeat. Should I be concerned and seek a second opinion? Recently have had more difficulty with small cuts bleeding more than usual. Thank you.
Fri, 12 Jun 2015
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Pathologist and Microbiologist,  's  Response
Hi, This condition of decreased platelets is called thrombocytopenia in medical terms. Decreased platelet count may have several causes such as drug induced , immunological causes, HIV infection etc. From the description that you have given your condition appears to be adult ITP ( IMMUNE THROMBOCYTOPENIA ). It occurs due to molecules called autoantibodies on the platelets surface which destroys the platelets. Autoantibodies in simple terms is like an army that attacks the people of its own country. I would suggest that you get a peripheral smear evaluated along with your complete blood count by a hematopathologist. You may also get a Coomb's test done to find out if there are other immunological problems that are getting your platelet count down. I presume that your initial work up would have also included HIV testing as HIV can also cause low platelet count. However in your case this does not appear to be the cause. The most important advice I would give is to monitor your platelet count regularly. Repeating the bone marrow test is not necessary for ITP as the problem is not in the marrow. If the platelet count falls below 50, 000/ cu.mm then your doctor should be notified. Platelet counts below 20,000 have a risk for causing bleeding within the brain. Adults with platelet counts >50,000/mm3 do not require treatment. Treatment is indicated for adults with counts < 50,000/mm3 with significant mucous membrane bleeding. Treatment also is indicated for those adults with risk factors for bleeding (eg, hypertension, peptic ulcer disease, vigorous lifestyle) and in patients with a platelet count < 20,000-30,000/mm3. If your platelet count falls to a very critical range your hematologist may treat you with medication such as glucocorticoids, IVIg immunoglobulin or newer drugs. However as your platelet count at the moment is not critical what is usually done is to monitor the platelet count. Because of an increased risk for bleeding aspirin products also should be avoided. Some adult patients with ITP slowly recover over time whereas some have a fall in their platelet count which requires treatment if it is very low. So please continue monitoring your platelet count as before .Best regards.
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What Causes Decreasing Of Platelet Count From 160000 To 80000?

Hi, This condition of decreased platelets is called thrombocytopenia in medical terms. Decreased platelet count may have several causes such as drug induced , immunological causes, HIV infection etc. From the description that you have given your condition appears to be adult ITP ( IMMUNE THROMBOCYTOPENIA ). It occurs due to molecules called autoantibodies on the platelets surface which destroys the platelets. Autoantibodies in simple terms is like an army that attacks the people of its own country. I would suggest that you get a peripheral smear evaluated along with your complete blood count by a hematopathologist. You may also get a Coomb s test done to find out if there are other immunological problems that are getting your platelet count down. I presume that your initial work up would have also included HIV testing as HIV can also cause low platelet count. However in your case this does not appear to be the cause. The most important advice I would give is to monitor your platelet count regularly. Repeating the bone marrow test is not necessary for ITP as the problem is not in the marrow. If the platelet count falls below 50, 000/ cu.mm then your doctor should be notified. Platelet counts below 20,000 have a risk for causing bleeding within the brain. Adults with platelet counts 50,000/mm3 do not require treatment. Treatment is indicated for adults with counts 50,000/mm3 with significant mucous membrane bleeding. Treatment also is indicated for those adults with risk factors for bleeding (eg, hypertension, peptic ulcer disease, vigorous lifestyle) and in patients with a platelet count 20,000-30,000/mm3. If your platelet count falls to a very critical range your hematologist may treat you with medication such as glucocorticoids, IVIg immunoglobulin or newer drugs. However as your platelet count at the moment is not critical what is usually done is to monitor the platelet count. Because of an increased risk for bleeding aspirin products also should be avoided. Some adult patients with ITP slowly recover over time whereas some have a fall in their platelet count which requires treatment if it is very low. So please continue monitoring your platelet count as before .Best regards.