What Are The Underlying Causes For Drop In Platelet Count In Children?

Posted on Sat, 21 Dec 2013

Question: sorry - my daughter is 4 years old and she very low neutrophil counts ranging from 100 -900 on any given day. during a regular blood test she had a count of 90, we were concerned and took her sick kids ... normally she is very energetic and a healthy little girl. they said they completed a smear test and all the cells produced seem to be mature and the right shape. they do not suspect cancer. they are testing for cyclical neutrophnia right now as her county seems to be very low for the past couple of months. I have been monitoring her lab reports and although her playlets are normal they seem to be steadily dropping for the past month from 330 to 230 .. should I be concerned

Answered by Dr. Krishna Kiran Kannepalli (11 hours later)

Brief Answer: Infections should be recognized and treated early Detailed Answer: Hi! Thanks for providing these details. I will not be concerned with the drop in platelets from 330 to 230. It is still in the normal range. I would like to know if the doctors have done a bone marrow aspiration. This should be clinching the reasons. The important thing is that any fever in such kids should not be taken lightly. Once cancer has been ruled out, there isn't cause for much worry. There are injections available to raise the neutrophil count (known as Filgastrim). These can be given once a cause for neutropenia has been established after bone marrow aspiration. If your doctors are not considering this at all I think the issue is benign to be concerned about. Infections can lower neutrophils. If infections can be recognized and treated early before they become life threatening, there will be no danger to the kid. Best wishes

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Krishna Kiran Kannepalli (37 minutes later)

Thanks Dr. The Sick Kids doctors do not want to complete a Bone Marrow Aspiration, further she did get a fever over the weekend 38.5 degrees. We took her in to the hospital and blood was drawn from her to see what the count would be .. .and she had a ANC count of 900. At this point they did send us home.. during her fever and cold her CBC came back and LYMP dropped to 1.5 should be 3.0 is this normal?

Answered by Dr. Krishna Kiran Kannepalli (1 hour later)

Brief Answer: Be watcful for recurrent fevers Detailed Answer: Hi! I did not understand what LYMP meant. If it means that the lymphocyte count was 1500 then it is below normal for a kid. It makes her susceptible to infections. But if means platelets, you need not worry. The normal range is between 120000 and 400000. The doctors may contemplate a bone marrow aspiration if the neutropenia recurs. You can leave it to their judgement. They must have given you antibiotics for the fever. If the fever however doesn't subside, she needs to be hospitalized. I therefore suggest you to be watchful. Best wishes

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Krishna Kiran Kannepalli (47 minutes later)

Thanks .. she completed anothe BCB today and platelets are up to 250 and the lymphocyte is up to 2700. The fever is gone. however neutrophil count has dropped to 100.