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What Causes Petechiae With Normal Platelet Count?

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Posted on Thu, 24 Dec 2015
Question: My 22 month old son came down with what was though to be petechiae from a virus. His CBC drawn 4 weeks ago was completely normal (platelets, WBC, Hgb ALL normal) but was covered from head to toe in petechiae. They are non blanching pin prick sized reddish purple (some are brownish) spots. 2 weeks after the first CBC was drawn I became concerned because the petechiae weren't going away at all! They maybe were not worse but certainly not any better. Because of this, I took him to see my pediatrician locally and she ordered a repeat CBC w/ diff. This also came back completely normal. Keep in mind he has NO symptoms. No fever, No loss of appetite, and he is acting completely normal. Because this second CBC came back normal my pediatrician is not concerned. However, now we are going on almost 5 weeks of full body petechiae! Even new petechiae are appearing as the old ones fade so it looks as if he is not getting any better. How can he have petechiae with a normal platelet count? I consulted 2 physicians through this website who were very helpful. One was a pediatrician and the other a hematologist. They both felt there was not real cause for concern due to the 2 normal CBC's. One of them advised I consult dermatology so I am hoping you can provide me more insight. Thank you.
doctor
Answered by Dr. Dr. Kakkar (4 hours later)
Brief Answer:
Need more information and a few Images

Detailed Answer:
Hello. Thank you for writing to us

I have gon ethrough your query and I have noted down your concern. I would like to gather more information from you in order to be able to guide you better.

Are they scaly? Do they involve the scalp as well? Do they particularly involve the inner part of arms and the calves? Can you upload a few clear Images of the affected areas?

You may upload an Image either at "Reports Section" Or You may mail me at YYYY@YYYY with the subject line of this mail as Attention:Dr.Kakkar.

Regards
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Dr. Kakkar (2 hours later)
They are not scaly. You cannot feel them as theyre just petechiae and therefore under the skin. They arent on the scalp that i can see. Mainly above nipple line and on face but on stomach, back, buttock, and legs too.
doctor
Answered by Dr. Dr. Kakkar (22 hours later)
Brief Answer:
I suggest a test for platelet function

Detailed Answer:
Hi.

This could be a platelet function defect since the platelet number is normal. I would suggest a test for clotting time which would suggest whether platelet are functioning normal or not. As far as treatment is concerned I would suggest a vitamin C supplement once daily.

Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

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

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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What Causes Petechiae With Normal Platelet Count?

Brief Answer: Need more information and a few Images Detailed Answer: Hello. Thank you for writing to us I have gon ethrough your query and I have noted down your concern. I would like to gather more information from you in order to be able to guide you better. Are they scaly? Do they involve the scalp as well? Do they particularly involve the inner part of arms and the calves? Can you upload a few clear Images of the affected areas? You may upload an Image either at "Reports Section" Or You may mail me at YYYY@YYYY with the subject line of this mail as Attention:Dr.Kakkar. Regards