Enlarged spleen

[Buickriviera88]

My son was first diagnosed with ITP in 2016 with platelets in 4 ; he was 17 years old.He was in the hospital for 2 weeks and received IVIG and winRho. The adverse reactions to this two medications were really nasty to the point that the hematologist decided that he is allergic to both of them and don’t suppose to use it again. After that, the doctor decided to use steroids and he was released from the hospital on a low dose of oral prednisone for 6 months. After this treatment he was in remission for 2 years. In March of 2018 and after a really bad cold his platelets went down again to 19. He never experienced any bleeding but because of his age ( he’s now 19) and his lifestyle that includes sports the hematologist decided to try steroids again. This time was dexamethasone for 4 days. He responded really well to steroids and his platelets went up to 250 in 7 days. But after 1 month dropped again to 19. A second course of steroids was given. Now platelets are up and down. This week count was 138. My only concern is that the ultrasound showed his spleen enlarged at 13.2 cm and I don’t know if this is expected. The doctor said the normal spleen measure is about 11 cm. Now I’m worried about something else going on. His CBC was normal except for the platelets. His Hgb is 15.7 and WBC normal. Did somebody else with ITP have enlarged spleen?

[Shoni89]

It may be worth doing a bone marrow biopsy. Generally with ITP platelets go up and down and thats what has happened. But enlarged spleen is a worry.

[JBSS]

If his spleen is enlarged then he might actually have a better response with remission with removal of spleen. Please discuss it with your hematologist.

[Kyriak51]

The spleen is enlarged because is destroying the platelet. Please tell me that your son is being followed by a hematologist. I’ve had ITP since early 1990’s and my spleen is not enlarged. This site has a great educational section, please check it out and learn as much as possible as you can about ITP and treatment options. Be well Georgia