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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Low Platelet Count?

My granddaughter is 20 years old, 12 weeks ago her platelets dropped down to around 20 for the first time in her life, she has been on steroids since but they only improved with the first high dos, now her platelets have dropped again once the dosage was dropped down. With no improvement they kept plummeting. She has had the bone marrow test and they are really good. so no problem there. The haematologist she is under now wants to take out her spleen. He has said that there is nothing else he can do as she would have to stay on drugs that could cause more problems. Isn t it too early yet as her platelets could come up eventually.
Mon, 5 Jan 2015
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
Steroids are known to reduce the number of platelets in blood.
Spleen is the site where platelets are destroyed so removal of spleen will improve the survival of platelets.
As stated by your hematologist that removal of platelets is the only treatment of choice since steroids have to be continued.
Thus, continue with your steroids and go for splenectomy.
Removal of spleen is associated with increased incidence of infection with encapsulated bacteria.
Immunization against these infections will prevent infection with these encapsulated bacteria.

Thanks and take care
Dr Shailja Puri
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What Causes Low Platelet Count?

Hello and welcome to HCM, Steroids are known to reduce the number of platelets in blood. Spleen is the site where platelets are destroyed so removal of spleen will improve the survival of platelets. As stated by your hematologist that removal of platelets is the only treatment of choice since steroids have to be continued. Thus, continue with your steroids and go for splenectomy. Removal of spleen is associated with increased incidence of infection with encapsulated bacteria. Immunization against these infections will prevent infection with these encapsulated bacteria. Thanks and take care Dr Shailja Puri