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What Causes Low Platelet Count Along With Joints Pain?
Question: Hello, I am a 34 years old woman, and I am very afraid I may have a serious health problem.
For the last 9 months, I got regular platelet count by blood tests. In all the results, the platelets counts are lower than the minimal required number (which is 140 in Quebec, Canada). My number of platelets have varied in this way : on Febuary 19, 134; on April 22, 96; on XXXXXXX 16, 150; on October 11, 138; on October 26, 115, and on November 9, 129. Before having my daughter (3 years ago), the platelets counts were around 200. When I was pregnant of her, the lowest platelet count I had was of 165. Since the blood tests when I was pregnant until Febuary 19, 2016, I haven't been monitored on platelet count.
As of medication, I was taking Zoloft (sertraline) at 50mg dose for a year, but I stopped taking it at the month of April.
Before the actual situation, I had some periodical pains in my joints, particularly in my hands. I did not have any other specific symptoms. The only thing that can be worth telling you is that I always had more ecchymoses easily than most of people do.
On november 7, I have seen a generalist doctor in a private clinic, and she gave me a prescription to go see a hematologist. She did check me out. She checked on my lymph nodes, and she has not felt any difference. She also ckecked my abdomen, and all seemed fine.
Since that day, I got a lot more symptoms. I feel that my lymph nodes are swollen, and I feel that they are painful (particularly on right armpit and right neck). I have a loss of appetite, a loss of weight (6 pounds over the last month), and I also have a diarrhea .
I am a person who is anxious about my health, that is the reason why I was taking sertraline.
Here are my questions :
In your opnion, with the information I gave you, what can be the cause of my symptoms? Can it be cancer ( leukaemia, myeloma or lymphoma) ???
If it is not cancer, can it be an auto-immune disease (but negative ana)?
I am joining you the blood tests results I was talking about, except for the ones of November 9. I don't have the results at home.
Thank you
For the last 9 months, I got regular platelet count by blood tests. In all the results, the platelets counts are lower than the minimal required number (which is 140 in Quebec, Canada). My number of platelets have varied in this way : on Febuary 19, 134; on April 22, 96; on XXXXXXX 16, 150; on October 11, 138; on October 26, 115, and on November 9, 129. Before having my daughter (3 years ago), the platelets counts were around 200. When I was pregnant of her, the lowest platelet count I had was of 165. Since the blood tests when I was pregnant until Febuary 19, 2016, I haven't been monitored on platelet count.
As of medication, I was taking Zoloft (sertraline) at 50mg dose for a year, but I stopped taking it at the month of April.
Before the actual situation, I had some periodical pains in my joints, particularly in my hands. I did not have any other specific symptoms. The only thing that can be worth telling you is that I always had more ecchymoses easily than most of people do.
On november 7, I have seen a generalist doctor in a private clinic, and she gave me a prescription to go see a hematologist. She did check me out. She checked on my lymph nodes, and she has not felt any difference. She also ckecked my abdomen, and all seemed fine.
Since that day, I got a lot more symptoms. I feel that my lymph nodes are swollen, and I feel that they are painful (particularly on right armpit and right neck). I have a loss of appetite, a loss of weight (6 pounds over the last month), and I also have a diarrhea .
I am a person who is anxious about my health, that is the reason why I was taking sertraline.
Here are my questions :
In your opnion, with the information I gave you, what can be the cause of my symptoms? Can it be cancer ( leukaemia, myeloma or lymphoma) ???
If it is not cancer, can it be an auto-immune disease (but negative ana)?
I am joining you the blood tests results I was talking about, except for the ones of November 9. I don't have the results at home.
Thank you
Brief Answer:
Hello dear. No need to afraid
Detailed Answer:
Hello dear. I have gone through the details. Your reports seem to be ok. The platelet counts can vary from day to day and even in the same day as new platelets keep on forming and older ones getting destroyed at variable pace. I donot see any cancer in your reports and since the clinical examination also was normal, there is actually no need to worry. You might have some milder form of immune thrombocytopenia which is the cause of easy ecchymoses and borderline mildly low platelets but even in that case any count above 50000 is acceptable as it rules out spontaneous bleed. One morw thinf.. You can get following tests done to rule out othet causes of low platelets
Folate level
B12, level
Hiv
Hcv
Thanks and regards
Hello dear. No need to afraid
Detailed Answer:
Hello dear. I have gone through the details. Your reports seem to be ok. The platelet counts can vary from day to day and even in the same day as new platelets keep on forming and older ones getting destroyed at variable pace. I donot see any cancer in your reports and since the clinical examination also was normal, there is actually no need to worry. You might have some milder form of immune thrombocytopenia which is the cause of easy ecchymoses and borderline mildly low platelets but even in that case any count above 50000 is acceptable as it rules out spontaneous bleed. One morw thinf.. You can get following tests done to rule out othet causes of low platelets
Folate level
B12, level
Hiv
Hcv
Thanks and regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello again;
I am also worried about autoimmune disease that are linked to a low platelet count (ex: lupus). Is it a possibility even if my AntiNuclear Antibodies are being tested as negative ?
Before my daughter, I had 2 miscarriages. Is it possible that it can be due to the Antiphospholipid Syndrome ?
I would like to know why do you rule out the possibility of cancer ?
Finally, do you think that the lasts symptoms that occured may be caused by somatization ?
Thank you again
I am also worried about autoimmune disease that are linked to a low platelet count (ex: lupus). Is it a possibility even if my AntiNuclear Antibodies are being tested as negative ?
Before my daughter, I had 2 miscarriages. Is it possible that it can be due to the Antiphospholipid Syndrome ?
I would like to know why do you rule out the possibility of cancer ?
Finally, do you think that the lasts symptoms that occured may be caused by somatization ?
Thank you again
Brief Answer:
Hello. Lupus is a remote possibility
Detailed Answer:
Hello dear. As of now you donot fullfill the criteria for lupus. Just on the basis of low platelets, we cant label you as lupus. Initially ana can be negative in lupus also, but there must be other criteria also. Antiphospholipid may be a possibility if you had pregnancy loss after 10 weeks plus eith apla or acla antibody positivity.
Lymphoma must present with palpable nodes which are painless, and leukemia usually causes prigressive alteration of leukocytes which you do not have.
Yes symptoms may be due to somatisation and i think you must not worry.
Hello. Lupus is a remote possibility
Detailed Answer:
Hello dear. As of now you donot fullfill the criteria for lupus. Just on the basis of low platelets, we cant label you as lupus. Initially ana can be negative in lupus also, but there must be other criteria also. Antiphospholipid may be a possibility if you had pregnancy loss after 10 weeks plus eith apla or acla antibody positivity.
Lymphoma must present with palpable nodes which are painless, and leukemia usually causes prigressive alteration of leukocytes which you do not have.
Yes symptoms may be due to somatisation and i think you must not worry.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello again;
As what I found on internet about immune thrombocytopenia, their platelet counts are much lower than mine. Have you seen immune thrombocytopenia with a platelet count around mine ?
About cancer, is the myeloma a possibility in my case ?
Actually, I am not reassured at all about the lymphoma. Is there anything else in my blood tests that rule out the lymphoma, because I have read that a low platelet count is often seen in the start of lymphoma ?
My platelet counts is going high and low and high again. Does that makes you think about something specific ?
I watched my menstrual cycle, and I think that the lowest results happened after my menstrual cycle. Is it linked ?
Thank you again
As what I found on internet about immune thrombocytopenia, their platelet counts are much lower than mine. Have you seen immune thrombocytopenia with a platelet count around mine ?
About cancer, is the myeloma a possibility in my case ?
Actually, I am not reassured at all about the lymphoma. Is there anything else in my blood tests that rule out the lymphoma, because I have read that a low platelet count is often seen in the start of lymphoma ?
My platelet counts is going high and low and high again. Does that makes you think about something specific ?
I watched my menstrual cycle, and I think that the lowest results happened after my menstrual cycle. Is it linked ?
Thank you again
Brief Answer:
Hello. I think you are allright
Detailed Answer:
Hello dear. I dont think its lupus or lymphoma. Moreover, myeloma is not a possibility in your case. You seem to be a minor variation of normal counts and you should not worry.
Thanks and regards
Hello. I think you are allright
Detailed Answer:
Hello dear. I dont think its lupus or lymphoma. Moreover, myeloma is not a possibility in your case. You seem to be a minor variation of normal counts and you should not worry.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello;
I do not think I am a minor variation of normal counts. In the past years (before my pregnancy of my daughter), my platelet count were around 200.
Also, I haven't got an answer to my questions. Here they are:
1) As what I found on internet about immune thrombocytopenia, their platelet counts are much lower than mine. Have you seen immune thrombocytopenia with a platelet count around mine ?
2) Is there anything else in my blood tests that rule out the lymphoma, because I have read that a low platelet count is often seen in the start of lymphoma ?
3) My platelet counts is going high and low and high again. Does that makes you think about something specific ?
4) I watched my menstrual cycle, and I think that the lowest results happened after my menstrual cycle. Is it linked ?
5) Does sertraline can change the platelet count ?
Thank you again
I do not think I am a minor variation of normal counts. In the past years (before my pregnancy of my daughter), my platelet count were around 200.
Also, I haven't got an answer to my questions. Here they are:
1) As what I found on internet about immune thrombocytopenia, their platelet counts are much lower than mine. Have you seen immune thrombocytopenia with a platelet count around mine ?
2) Is there anything else in my blood tests that rule out the lymphoma, because I have read that a low platelet count is often seen in the start of lymphoma ?
3) My platelet counts is going high and low and high again. Does that makes you think about something specific ?
4) I watched my menstrual cycle, and I think that the lowest results happened after my menstrual cycle. Is it linked ?
5) Does sertraline can change the platelet count ?
Thank you again
Brief Answer:
Hello dear. I think you have a minor variation
Detailed Answer:
Hello dear. Again i think your counts are ok. You have a variation ranging from 115 to 165 or so. Any count which is above 150 is taken as normal, but that does not mean that a count of 119 or 125 should be taken as abnormal as it is the sole abnormal parameter so far in your body.
What will prompt me for some more investigations is a falling trend of platelets which you do not have. or a single reading of less than 100 which again you do not have.
1. You are right that lupus have more lower counts of platelets but i have seen patients with a borderline count of 120 , 130 which developed lupus but only after a period of 5 to 7 years. Those had other criterias of lupus also which you do not have. Thats why i said that your chances of lupus seem remote.
2.Lymphoma diagnosis is not made on blood picture. It is made on the biopsy of node or from tissue. o there is actually nothing in the blood which will lead to the diagnosis of lymphoma. A low platelet counts is usually seen in lymphoma when the disease is already in a very advanced stage, and you do not have anything to suggest a lymphomas.
3. Not only your counts, but every patients count fluctuate (even mine) in a single day too, because rate of formation of platelet and their destruction are variable.
4. Again a minor variation with menstrual cycle may be seen with highest count in the middle and lowest counts in the end.
5. It is a very rare side effect of sertraline.
In my opinion, you should not chase any further investigations in the absence of any symptoms and just relax.
Thanks and regards
Hello dear. I think you have a minor variation
Detailed Answer:
Hello dear. Again i think your counts are ok. You have a variation ranging from 115 to 165 or so. Any count which is above 150 is taken as normal, but that does not mean that a count of 119 or 125 should be taken as abnormal as it is the sole abnormal parameter so far in your body.
What will prompt me for some more investigations is a falling trend of platelets which you do not have. or a single reading of less than 100 which again you do not have.
1. You are right that lupus have more lower counts of platelets but i have seen patients with a borderline count of 120 , 130 which developed lupus but only after a period of 5 to 7 years. Those had other criterias of lupus also which you do not have. Thats why i said that your chances of lupus seem remote.
2.Lymphoma diagnosis is not made on blood picture. It is made on the biopsy of node or from tissue. o there is actually nothing in the blood which will lead to the diagnosis of lymphoma. A low platelet counts is usually seen in lymphoma when the disease is already in a very advanced stage, and you do not have anything to suggest a lymphomas.
3. Not only your counts, but every patients count fluctuate (even mine) in a single day too, because rate of formation of platelet and their destruction are variable.
4. Again a minor variation with menstrual cycle may be seen with highest count in the middle and lowest counts in the end.
5. It is a very rare side effect of sertraline.
In my opinion, you should not chase any further investigations in the absence of any symptoms and just relax.
Thanks and regards
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Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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