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My platelet count continues to drop. It was 159 in 2015, 130…

Customer Question
My platelet count continues...

My platelet count continues to drop. It was 159 in 2015, 130 in June, and now 113 as of today.

Doctor's Assistant: Have you experienced any bleeding? Pain? Unintentional weight loss?

Lymphocytes are 18.2 / Monocytes are 14.2

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Fever x 1.5 weeks, joint pain, severe headches,

Doctor's Assistant: How long have you had the pain? What seems to make the pain better or worse?

Excessive tiredness. Joint pain and tiredness for several months.

Submitted: 11 months ago.Category: Oncology
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Answered in 2 minutes by:
8/2/2017
Oncologist: Dr.Saleem, Doctor replied 11 months ago
Dr.Saleem
Dr.Saleem, Doctor
Category: Oncology
Satisfied Customers: 3,425
Experience: MBBS
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Hello and welcome to JA. Dr Saleem here. Will be answering you shortly

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Oncologist: Dr.Saleem, Doctor replied 11 months ago

Sorry to know that. Would require some additional information on this .

Have you had any more tests other then the blood counts?

Any autoimmune profile done? Have they ruled out SLE, RA etc ? Tests specific to these conditions?

Did you always have fever when count was low?

Do you ever feel a mass in your upper left abdomen quadrant?

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Customer reply replied 11 months ago
CRP is elevated, ESR is elevated, ANA is normal, RF is low
Customer reply replied 11 months ago
No masses that I can feel
Oncologist: Dr.Saleem, Doctor replied 11 months ago

So there is inflammation there with both of CRP, ESR being elevated.

Any skin rashes? Hair loss? Nail changes? Dry eyes, dry mouth ?

Any bowel issues ? Any past urogenital infections?

Other cell counts i.e WBCs, RBCs are perfect?

Have they done complement levels?

Whats your age , gender?

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Customer reply replied 11 months ago
Nausea only. Urinalysis was normal. Blood and urine cultures normal. 62 y/o male. Only hx is IDDM
Oncologist: Dr.Saleem, Doctor replied 11 months ago

Alright well it needs to be thoroughly investigated as there is a long list of causes that lead to low platelet count or thrombocytopenia.

These include chronic infections, blood malignancies such as leukemia/ MDS, PNH, others like chronic liver or kidney diseases etc.

If none of these causes is found then it may well be idiopathic thrombocytopenia which has an autoimmune cause.

As your counts are still ok and you have no rash, bleed or any alarm symptoms which usually start with platelets as low as 20 ,so nothing much is required as far as treatment is concerned.

Cause however needs to be sought with the help of few more investigations which i can mention if you like.

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Oncologist: Dr.Saleem, Doctor replied 11 months ago

Needs a thorough systemic exam along with investigations that include ;

Peripheral blood smear

Liver functions

Virology for HBV, HCV and HIV

Coagulation profile

LDH

In the end bone marrow biopsy if all of the above are unremarkable.

hope it was helpful.

Feel free to ask any more queries.

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