One year old with low platelet counts - ITP??

[PranavJoshi]

Hi everyone,

At around his first birthday, we noticed several large bruises on my son's back and arms. We earlier discounted this as play-related since he is a very active baby who started walking at 10mths age. There were no other symptoms such as bleeding or fatigue.

His pedia looked at the bruises and advised getting a blood test, and his count was 23. She feared ITP and advised to get him admitted and get a bone marrow analysis done.

We were freaked out by then - he looked completely normal, without any fever, any bleeding or any swellings anywhere. His height/wt/appetite were also proper for this age. That's when the doctor told us about ITP.

We went for 2nd opinion a few days afterwards, and the count was up to 31. The 2nd doc advised to do nothing, and repeat a blood test a week afterwards. That time, his counts were 76 but his hemoglobin was on the lower side, with hypochromic RBCs.

We were now worried whether it was something else apart from ITP. For the next two weeks, we upped iron content in his diet (lots of beetroot and leafy greens) and repeated a blood test. In the meantime, in the last week he has started to show a few bruises and some petechiae. A few of the bruises we could correlate to a barked shin and forearm, but the non-obvious ones are not as bad as they were when we noted them first time around.

His plate counts are not out yet, since they do it by smear in our lab. But his hemo has improved and all his other cell counts remain normal:)) We do not give him any other medications.

However, the poor thing hates blood tests and is traumatized for days after the experience. That's why we have never considered bone marrow analysis. We will monitor him for 5 months (until he is 1.5yr old) and see whether any invasive procedure is needed

My Q is, how long will it take for ITP to resolve in a 1yr old, and how common is the fluctuation in plate-counts in this case?

Thanks

[Nasar]

your approach is correct, you need to wait and watch as many of the paediatric ITP can go away without medication. Pls read below articles, its gives tones of info. good luck for your baby.

bloodjournal.hematologylibr...

[PranavJoshi in reply to Nasar]

Thanks Nasar for your comment..exactly the article that I had read, along with articles from James George of Oklahoma.

As latest update, I am happy to report that his latest plate count is 100 and all other numbers are normal.

[Nasar]

Its Good to hear that the count goes up. Lots of love to your baby,