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Suffering from low platelet count. Rashes on the body, loss of appetite. Taking omnacortil and thyroxine. What should be the further treatment?

My daughter is suffering from low platelet count since last one and a half year. She never went down by dengue or any other disease ever. suddenly rashes over whole body started in September 2011. Doctor took it as allergy infection. The same were got disappeared in October, 2011. In April, 2012, the same system with loss of apetite again resurfaced. The platelete count went down upto 0000 only. She was given a bag of platelets in Balaji Action Hospital. Biopsy report suggested big size & short life Platelet. She remain under treatment with Thyroxin and Omnacotil steroid . Now again since last 20 odd days, the same system again surfaced. Platlete count again going down around 0000. Please guide me what treatment should I give to my daughter and also suggest any clinical test as per the symptoms mentioned above..
Asked On : Tue, 26 Mar 2013
Answers:  1 Views:  74
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General & Family Physician 's  Response

Based on the information it seems

The problem is SOME WHERE IN THE STEM CELLS which produces the PLATELET CELL STREAM as the other CELL linage like leukocytes and the red cell are normal as per the given information , as well as do not had any viral fevers like dangue so,.

Probable diagnosis : - selective PLATELET production problem.

The big size platelet and short life platelet is mostly associated with

1) Low, THROMBOPOIETIN - production from liver (required to stimulate the growth of platelet).
2) Low, vitamin B12& FOLIC ACID (required to proper production of platelet).
3) Bernard–Soulier syndrome - lack of "glycoprotein Ib "- genetic disorder
4) May–Hegglin anomaly- rare genetic disorder.
5) Congenital amegakaryocytic thrombocytopenia - genetic disorder.

***** FURTHER Investigation needs to be done
a) Bone marrow biopsy to check any genetic disorder,
b) blood test to check levels of other factors
c) check for infection present.

***** CONSULT -HEMATOLOGIST (blood doctor)

Now the treatment option varies with the cause
1) Replace THROMBOPOIETIN if low.
2) give vitamin B12, and folic acid if low
3) lithium carbonate and folic acid stimulates the platelet production
4) need platelet transfusion if above mention steps do not work

5) last and final option is "BONE MARROW TRANSPLANT"

Answered: Wed, 27 Mar 2013
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