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Bleeding and Clotting Disorders

Highly decreased platelets

02/18/2008

Question:

I did a platelets test beginning of January and it was 105,000/cmm. The lowest thus far was about 71,000/cmm more than a month ago, but has since increased. However, earlier this week i discovered that I had a small outbreak of tiny red-blood-like spots on my arms. Instead of going back to the hospital immediately as cautioned by doctors, I went for a blood test and my fears were confirmed with my platelets at 60,000/cmm. A 45,000/cmmm decrease in a month is alarming, and I did a re-test two days later and it was 75,000/cmm. I don`t know what to do just yet except to wait for another week or two for another test. I noticed that when I feel stressed out, the red spots will increase. Or can it be due to viral infection as well? Do I need to go back t the doctor if by the next test my counts have not improved? They still don`t know what`s wrong with me yet, so doctors are putting it under ITP.

Also, I have been feeling giddy each time I bend/squat down even for a minute or two. I can`t climb more than three or four flights of stairs without stopping for breath, and I`m only 21 this year. My HgB has been sufficient, but at a borderline of less than 14. What can be the problem?

Answer:

While it is difficult to make a diagnosis with limited information, and without being able to speak with you and examine you, what you are describing could be consistent with ITP. The platelet counts that you describe may just be normal variation from different measurements at different times. Overall you seem to be in the range of 40-100, which has been relatively stable over time.

Patients with very low platelet counts (typically less than 20,000) can get small dots on the skin called petechiae, but your platelet count seems to have been much higher than this.

I would encourage to be seen by a hematologist who can answer your questions regarding ITP and your symptoms. ITP is a disease that does not have a test that confirms the diagnosis, but rather the diagnosis is made by excluding other possible causes for an isolated low platelet count.

For more information:

Go to the Bleeding and Clotting Disorders health topic, where you can:

Response by:

Spero R Cataland, MD Spero R Cataland, MD
Associate Professor of Clinical Internal Medicine
College of Medicine
The Ohio State University