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ITP Support Association
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Extremely Low Platelets

Hi, my sister in law is in the hospital in Florida and her platelet number is 4-8 and they can not get it up and even after a bone marrow biopsy can not figure this out! We are very worried and I am wondering if anyone else has gone through a similar experience. She is 66 years old and is a diabetic.

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I had a bone marrow test over a years ago. In people with ITP, the bone marrow will be normal because a low platelet count is caused by the destruction of platelets in the bloodstream and/or spleen (so they say!) — not by a problem with the bone marrow.

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ITP can be cause be either the destruction of platelets by the immune system or the production of platelets in the Bone Marrow. The tests that are designed for ITP are tests to rule out causes. Such as your Bone Marrow Biopsy. Drugs such as Nplate are designed to stimulate Bone marrow production in individuals whose primary ITP is cause by low production of Platelets. I also had a bone Marrow Biopsy and I too was told that my Bone marrow was producing. However, ITP can also be caused by a combination of both low production and a high rate of destruction of platelets by the immune system. Each case is unique and doctors are learning that genetic also play a role in ITP.

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What treatments/medication have they tried to bring up her count? I was given IVIG & Prednisone, which took a few days to bring it up from 8 to 26. I know others have had platelet transfusions. I've never had a bone marrow biopsy, so no help there.

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The Bone Marrow Biopsy will just be to eliminate a more serious condition called myelodysplastic syndrome. To get your sister in law's count to rise quickly she will probably be given IVIG (Intravenous Immunoglobulin). Unless your sister in law is experiencing severe bleeding incidents then there may be no cause for too much concern, although at her levels she does need intervention.

IVIG is a rescue remedy and usually gives quick results. It only usually works for two weeks to a maximum of a month. This gives doctors the chance to try other medications.

If it helps I am 63 and have had refactory ITP since 2011. In the last 6-9 months my count has only got into double figures twice. My count last Friday was 1. I have IVIG every week at the moment.

I'm still here!

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I was diagnosed at 69 a year ago when I noticed unusual bruising and a blood test diagnosed low platelets my reading was 12. IVIG prednisilone and a bone marrow test ensued but as previous contributers have said a bone marrow test is to rule out Cancer of the blood. IVIG is just a stop gap there are quite a number of drugs that may help ITP the main thing is to stay positive watch for unusual bruising and protect your head from knocks. I hope your sister in law finds a medication that will control the condition for her try not to worry and give her lots of TLC.

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I had IVIG and it gave me a retinal bleed, so not all treatments work. NickyD

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True! My son is 17 and was diagnosed with ITP last month. He had very bad reactions to IVIG and WinRho. Even when IVIG rise his platelets from 2 to 174,000 the hematologist decided that he is allergic to these type of products and cannot use them again. Now he is in prednisone . This week he is taking 10 mg. The platelets count was 140,000 last Thursday. I'm just praying for his recovery. I feel sad and depressed because he is a healthy adolescent and just in the last month we had to run to the ER twice with platelets counts in 2 and 5.

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I had two bone marrow tests/biopsy done. I was told by Hematologists that this will show if my bone marrow produces the platelets the way it should be or the caused. It also allows them to rule out any other illness or cancer before they can identify it as itp. I believed it since one of the Hematologists who performed the bone marrow tests while I was out of the country vacationing & saw my unusual bruising is my sister in law.

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In my case, the bone marrow produces enough platelets but my nuclei which is immune system destroys the platelets faster than the bone marrow can produce (it takes time for the platelets to mature in the bone marrow) so sometimes a repeat on blood test is necessary since no reading or count can be done on platelets that are too young if your bone marrow replaced the ones that were destroyed by the immune system before it matures.

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