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Hi Doctor, I Need An Opinion Regarding My Cousin S

Posted on Mon, 5 Nov 2018

Question: Hi Doctor,

I need an opinion regarding my cousin's report. He around 48 years and his blood platelets have gone down drastically in last 4 months. It was around 80000 4 months back but now it has come down to 50000 and even the dengue and malaria are negative. Need an opinion on the blood reports attached and next steps that's needed.

Answered by Dr. Shailja Puri (55 minutes later)

Brief Answer:
Investigations show a positive Dengue NS 1 antigen

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
One of your reports reported on 17-10-18 shows dengue NS 1 antigen to be positive.
This test is suggestive of infection by Dengue fever.
The fall in platelets is due to Dengue infection.
I suggest you to consult your primary healthcare provider for supportive care and monitoring of platelet count.
The platelet count starts improving once the supportive care is provided.

If you have more queries, I will be glad to answer.

Thanks
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Shailja Puri (4 hours later)

Thanks Doctor.

However the dengue test shows it negative and why is the platelet going down from last 4 months and why the weakness is only there from last few days. I don't think that he is suffering from dengue from last 4 months.

Follow up: Dr. Shailja Puri (8 hours later)

Hi Doctor,

I have attached 3 reports of Mr. XXXXXXX XXXXXXX Please go through those reports and let me know.

Thanks

Answered by Dr. Shailja Puri (8 hours later)

Brief Answer:
The Debgie NS1 antigen is +tive, serological test is -tive

Detailed Answer:
Hello and welcome again,
I have gone through all your reports.
The reports show a positive dengue NS1 by ELISA and negative Dengue Ig M.
Presence of positive Dengue NS1 by ELISA is confirmatory for Dengue, however, Ig M is a serological test.
Dengue Ig M is an antibody which takes some time to appear is blood after acquiring infection.
The report dated 17-10-18 is positive for Dengue.
Ig M may take few more days to become positive.
The reports do not suggest any chronic illness from four months, however, after recovery from Dengue, the platelets are expected to come to normal level.
If the platelets still remain low after recovery from dengue then other possibilities have to be considered.
However, as of now, you need to consult your primary healthcare provider for management of current infection.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Shailja Puri (1 hour later)

Thanks Doctor.

Here the doctors have ruled out the chances of Dengue. Please ignore all the reports and only go through the new reports of Mr. XXXXXXX XXXXXXX There are 3 reports Report 1, Report 2, Report 3.

Previous reports also contain the reports of Mrs. XXXXXXX and yes she is suffering from Dengue but I need the opinion on only Mr. Nilesh's report which i have attached again as Report 1, Report 2 and Report 3.

It will be helpful if you can provide an input on those three reports.

Follow up: Dr. Shailja Puri (2 minutes later)

As doctors in XXXXXXX hospital has ruled out Dengue and has referred to a Haematologist so need a 2nd opinion on the same that whether it's really needed to meet a Haematologist.

Answered by Dr. Shailja Puri (9 minutes later)

Brief Answer:
Low platelets can be due to decreased production/increased destruction.

Detailed Answer:
Hello and welcome again,
Going through report 1, 2 and 3, a reduction in platelets is noted.
There is a need to consult a hematologist for the reduction in platelets.
To enumerate causes of reduction in platelets count, common ones are recent viral infection, ITP (idiopathic thrombocytopenic purpura), destruction of platelets due to drugs etc.
Is there any history of any recent viral infection (fever) drug intake?
If no then there are chances of ITP.
ITP is characterized by fever accompanied by reduction in platelet count.
I suggest you to consult a hematologist for relevant investigations and thus management.

Thanks and take care
Dr Shailja Puri

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Above answer was peer-reviewed by : Dr. Yogesh D