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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With ITP. Platelet Count Very Less. Taking Prednisol Injections, Wysolone, Not Much Improvement. Solution?

I have been diagnosed with ITP last month. My platelet count at that time was only 4000. After 1 gm Prednisol Injection for 3 days, i was put on steroids (Wysolone 65 mg) as per my body weight, My dose is being tappered every 8 days, This time i am taking 45 mg wysolone.......I am not seeing much improvement in platelet count...After Prednisol injections Platelet count was 0000, After taking wysolone it dropped to 0000, Now it is 0000......Guide me to some better Doctor..................My all tests are Fine except one i.e H-Pylore..I am taking medicine for that
Fri, 25 Oct 2013
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General & Family Physician 's  Response
hello there!
what is 0000? i believe its 10 thousand.
first of all ITP is diagnosis of exclusion. So lets assume you haave been ruled out for all other possible causes of thrombocytopenia, here is what we gonaa do but first
did u have any bleeding episodes? severe hemorrages etc?
Airways breathings , were they ever needed to be maintained with external aids?
have any one ever checked your intra cranial pressures?have you ever lost hemodynamic stabality ( blood loss enough to give you a shock. low bp etc)

i will say hae your self checked by a neurosurgeons for assessing intra cranial hemorrhages risk, and a hematologists to reconfirm the diagnosis. some times its too early to say its ITP.as you are not responding to the meds.

now consider you are diagnosed correctly and you are not responding to the treatment it means your case is abit resistant.

so steroids wont be enough for you.

you need platelet transfusions right after the dosages of IVIGs(intravenous immunoglobulins) this will help reduce the lysis.

add some thrombopoetic agents to your diet( platelets producing stimulators) like promacta(eltrombopag) and Nplate (Romiplostim) .

and if these medications fail too which i am sure they wont

you will need to get rid of the spleen after vaccination for capsulated organisms. spleenectomy will solve the platelet lysis issues and will help the recovery.
lets hope medicines are enough to get you out of your miseries.

cheers.
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Diagnosed With ITP. Platelet Count Very Less. Taking Prednisol Injections, Wysolone, Not Much Improvement. Solution?

hello there! what is 0000? i believe its 10 thousand. first of all ITP is diagnosis of exclusion. So lets assume you haave been ruled out for all other possible causes of thrombocytopenia, here is what we gonaa do but first did u have any bleeding episodes? severe hemorrages etc? Airways breathings , were they ever needed to be maintained with external aids? have any one ever checked your intra cranial pressures?have you ever lost hemodynamic stabality ( blood loss enough to give you a shock. low bp etc) i will say hae your self checked by a neurosurgeons for assessing intra cranial hemorrhages risk, and a hematologists to reconfirm the diagnosis. some times its too early to say its ITP.as you are not responding to the meds. now consider you are diagnosed correctly and you are not responding to the treatment it means your case is abit resistant. so steroids wont be enough for you. you need platelet transfusions right after the dosages of IVIGs(intravenous immunoglobulins) this will help reduce the lysis. add some thrombopoetic agents to your diet( platelets producing stimulators) like promacta(eltrombopag) and Nplate (Romiplostim) . and if these medications fail too which i am sure they wont you will need to get rid of the spleen after vaccination for capsulated organisms. spleenectomy will solve the platelet lysis issues and will help the recovery. lets hope medicines are enough to get you out of your miseries. cheers.