Thank you for your query. I can understand your concerns.Immune thrombocytopenic purpura
(ITP) is an acquired disorder in which there is immune-mediated destruction of platelets and possibly inhibition of platelet release from the megakaryocyte.
ITP may be associated with other autoimmune disorders
, particularly systemic lupus erythematosus
(SLE) but not with diabetes of which Type 1 diabetes
Initial treatment in patients without significant bleeding symptoms, severe thrombocytopenia
can be instituted using single agents,traditionally steroid i.e.prednisone at 1 mg/kg to which your spouse responded (platelet count rose from 10000/c mm to 80,000/c mm).
(Bone marrow examination
is reserved for older adults (usually >60 years;your spouse is 67 years) or those who have other signs or laboratory abnormalities not explained by ITP, or in patients who do not respond to initial therapy.
Refractory thrombocytopenia (RT) may be due to Myelodysplastic Syndromes or the MDSs which can transform into refractory anemia with excess blasts in transformation (RAEB-t) / acute myeloid leukemia
. However his blood count is, normal (which is otherwise against possibility of MDSs) in all respects except for the sudden platelet drop last week.
Wait for the detail bone-marrow examination report. If inconclusive go for bone-marrow biopsy.
Dr. T.K. Biswas M.D.