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Bleeding and Clotting Disorders

Thrombocytopenia

04/11/2011

Question:

I`ve been diagnosed with ITP, with platelets ranging from 69k to 105k in the last 6 months. I know it`s not that low, but lately I`ve been feeling weaker and I wonder if it just happens to have something to do with platelets? I actually just saw the doctor yesterday, but this slipped my mind.

Another question: I`m currently under the care of a semi-government teaching hospital in my country, and so I sometimes see different doctors unless I request. Two doctors have said that I should start treatment (steroids) should my counts go below 50,000...while another doctor says he will only start treatment at 10,000. What is a safer range? I know that 10,000 is dreadfully low and potentially dangerous...

Answer:

The goal of treating ITP is to maintain a safe platelet count independent of, or at a minimum of treatment. In genera,l a safe platelet count is considered to be 20-30,000, but it is sometimes 50,000 based on the specific circumstances of an individual patient (increased risk of bleeding). Below 10,000 is considered at greatest risk for bleeding complications and absolutely should be treated.

There might be something to the weakness that you describe. There has been some work to suggest that fatigue may increase the lower the platelet count is in ITP. This is not thought to be directly related to the platelet count, but may be related to the effect of the immune response that is decreasing the 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