Indium labelled platelet scan ITP

[preethyb]

My mother has been suffering from ITP from 5 years, but her platelet count is not increasing, i would like to know if the culprit is spleen or liver, does any one know about indium labelled platelet scan

[Hidden]

I know of 2 people who have had the scan and as a result have not gone forward to surgery as it showed the platlets were being destroyed in the liver or 50 /50 with liver and spleen. Not a lot of places do it and its expensive and some heamos are dimsissive of it. I know if I had been given the option before my surgery I would have had it done. They remove platelets tag the and inject them back in then do various scans over a period of time to track them

[QT200QT600]

I had the scan at Derriford Hospital, Plymouth, UK. It revealed that the platelets were being sent to the liver for destruction and that as such, I would receive no benefit from having my spleen removed. I had this after the steroids would not hold up my platelet numbers, ie, reduction in the steroids led to a drop in the platelet level, and of course, they will not leave you in steroids unless there is no other option to keep you at a safe platelet level. I had also tried Mycophenolate but this appeared to be having little effect (and subsequently was shown to be having no effect). The scan took place over a week and a half. First they take some blood, separate the platelets, put indium markers on them and reinject them. You have scans on the first day too to see where everything is and what is going on at that point. I returned for shorter scans each day for the rest of the week and on the Monday and Wednesday of the following week. They then prepared a report that was sent to the consultant, outlining their findings. it is not at all scary and I found the staff in the nuclear medicine department really friendly, assuring and helpful. You do have to give some blood each day but most people with ITP will be old hands at this, and not afraid at all. As I said, if I had not had it, they could have reached the decision that I should have a splenectomy which would have had no benefit and severely reduced my immunity for life. The other benefit, in the UK is that if you are not a candidate for a splenectomy then NICE have authorised use of Romiplostim (Nplate) or Eltrombopag (Revolade), so you don't have to try the other drugs first before you go onto these.

[takari]

I recently had this done and it showed that I am mixed sequestration (both spleen and liver) so I am not a candidate for a splenectomy. They remove 60 ml of blood and separate the platelets and radiotag them with indium and put them back in. They then follow where the now glowing platelets go for a few days so they know where they are being destroyed. My hemo wanted me to get a splenectomy and I asked him about this test. He had never heard of it but he did check into it for me and I had it. I would recommend it for everyone considering a splenectomy. I had mine done at Crouse Hospital in Syracuse, NY and they will tell you that this test is not done in the US but they are wrong.

[preethyb]

Does any one know if we have this test available in India, if s where if is and how much it costs...

[owenm]

I went through it about 15 months ago.

Relatively simple procedure, I had mine in London at St Barts.

My consultant informed me the results showed that the spleen was the main site of Platelet destruction. I have however had no treatment for the last 15? months and have maintained a count in double figures throughout.

As long as I don't stay below 20 across my monthly tests I get left alone!!

Hope some of this might be of use!

Owen

[ITPAffecty in reply to owenm]

How are you maintaining it at 20? Even if mine is above 20, i will be fine. But it usually goes below 10 for more than 20 days in a month and i will devlop so many bruises all over the body and it takes months to get rid of them!!.

[Sunshine220]

Hello,

Sorry to report but I recently called Crouse Hospital in Syracuse NY and they no longer offering the exam!