Hi Everyone, New Diag, just started Pred...

Glad to have found you brave folks. I guess I'm scared but also relieved that I don't have cancer (pretty sure anyway.

First a big thanks to whoever vreated this site and people like Sandi who I see is on here posting and replying.

I'm a 37 yo male who works in construction and only after reflecting on results found out that I work around dangerous chemicals like benzene. Feeling angry at being put in jeopardy at the workplace for a job I hate and now unsure of career future. Not sure about the long term effects of exposure but can be cancerous. plat were around 40 but after pred this is my latest result:

ABS. IMM GRAN
0.0
K/MM3



ABS. NRBC
0.0
K/MM3



AUTOMATED NRBC
0.0
#/100 WBC'S



BASO
0.0
%
0-2


BASO #
0.0
K/MM3
0.0-0.1


EO
0.7
%
0-6


EO #
0.0
K/MM3
0.0-0.4


HCT
48.6
%
42.0-52.0


HGB
16.7
GM/DL
14.0-18.0


IMM GRAN
0.5
%
0.0-0.6


LYMPH
12.1
%
15-43
Low

LYMPH #
0.7
K/MM3
0.8-3.1
Low

MCH
28.5
PG
27.0-34.0


MCHC
34.4
g/dL
33.0-37.0


MCV
82.9
FL
80.0-94.0


MONO#
0.3
K/MM3
0.4-1.3
Low

MONOCYTE
5.3
%
4.5-10.5


MPV
14.4
FL
9.4-12.4
High

NEUT
81.4
%
44-76
High

NEUT #
4.8
K/MM3
1.3-7.0


PLT
53
K/MM3
150-460
Low

RBC
5.86
M/MM3
4.70-6.10


RDW-SD
34.7
FL
<47.0


WBC
5.9
K/MM3
4.0-11.0


Sorry, that's how it pasted. I would like to taper off the Pred ASAP and wondered what anyone would advise. Also are any other of these readings a possible indicator of anything else? Thank you so much!!

I have not read of any connection between chemicals and ITP, but a number of drugs can cause low platelets. More often, it seems that either an illness or a vaccine is the precipitating factor, but generally the cause is not known for sure.

High neutrophils and low lymphocytes can both result from taking prednisone.

MPV is a measure of the average size of your platelets. Your platelets are larger when new, and get smaller as they age. If your immune system is destroying your platelets, their "life expectancy" is reduced, so the average age of the platelets is younger, and the average platelet size is larger. For this reason, the MPV is often elevated with ITP.

Your platelet count of 55k is pretty decent for someone with ITP. Were they at 40k when you began treatment? Many doctors would not treat at that level, but would monitor your platelet counts. How much prednisone are you taking?

Thanks for the response Rob. The Dr prescribed a 60mg/day dose. I considered not opting for the steroids but I thought there might be a chance that after stopping my body would no longer see the platelets as an enemy. I would like to be able to taper off quickly because I already had chronic digestive issues which can be magnified.

Again considering the dangerous work environment, I would like to be safe in case of injury.

From what I've read Benzene is linked to ITP, luekemia and aplatic anemia, and other blood stuff. It seems like scary stuff and I'm not at all sure of what life decisions I should make besides avoiding it in the future.

Hi there. How long have you been on Prednisone so far?

Personally, I believe that chemicals can play a huge part in health issues of any kind. They are usually considered to be toxic for a reason.

Can't specifically address Benzene but I think, if that were the cause, removing Benzene from your environment would alleviate the platelet issue. I can assume you've already done that.

In the literature you'll notice that ITP is sometimes called 'primary' and sometimes 'secondary'. If Benzene was the cause that would (should) make ITP secondary.

Hi Sandi, just a week so far with Prednisone. I will listen to when you all might recommended that I start tapering off.

I tend to believe this chemical has played a roll and feel betrayed that its remained far from public knowledge as many things are

Hi Hal9000 (I've seen the 2010 film as well as 2001).

I'm not so sure about that in regards to benzene, some of the effects are not noticed until 10 years later...

I have read further regarding benzene and ITP, and you are right about the benzene connection. I was not surprised to learn that benzene toxicity could lower platelets; what really surprised me was learning that benzene can modify the immune system to create platelet antibodies.

You may want to read this article from OSHA:

www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10045
Title: Medical surveillance guidelines for Benzene

One quote that grabbed my attention:

It is evident that isolated cytopenias, pancytopenias, and even aplastic anemias induced by benzene may be reversible and complete recovery has been reported on cessation of exposure. However, since any of these abnormalities is serious, the employee must immediately be removed from any possible exposure to benzene vapor.

What does your hematologist think about your exposure to benzene?

I will read through that again Rob, think I just skimmed it last time but thanks to you I'll save the article this time!

The Hematologist was unaware and said he would look into it, so will not see him until a couple more blood draws.

Hal - Removing Benzene will not necessarily cause ITP to go away. Sometimes when damage to cells or bone marrow occurs, the damage is done. Also, ITP is considered to be primary in the absence of other illnesses, it has nothing to do with toxins or causes. For example, ITP is sometimes a symptom of other disorders such as Lupus and in that case, ITP is secondary.

Wquine - There are many, many toxins affecting public health that go under the radar. I won't go there right now, and I'm sure my fellow PDSA'ers will be grateful. However, ITP can also be triggered by a simple cold, so not everything is avoidable.

I am new here but not to auto-immune issues. My husband is also in construction, a stone mason.
When we took over the business from his dad in 1999 first thing I did was to access any health documentation re especially chimney work. The chemicals his dad worked in all his life, creosote, scared me to death. I was right. So the costs for our chimney repair are very high, due to equipment needed. Full body suits, gloves, masks etc. But you know dad was a healthy man his entire life, he was a mason for 40 years and he did not think about equipment...he leaving us at 72 year, only suddenly from a stroke.
I think Sandi knows plenty here. Chemicals are not some peoples friend in any amount. If you happen to have auto-immune tendencies and exposure maybe that's the ticket to destruction.
I ask wquine, have you a rheumatologist? Have there been tests done with regard to your immune system? Maybe if there is something living there that is not just right, that combined with the chemical has set this in motion for you. For example I have immunoglobulin issues, and auto-antibody issues. The testing which is simple for us, just a pin prick, speaks volumes to a good rheumatologist and an informed patient. My pin prick diagnosed SLE or Lupus for short, and sjogren's disease...then some other baggage as well. It's what I have learned this past few weeks here since my possible ITP. The doctor's say I have ITP, but for me, now, I am not yet convinced it isn't my Lupus diagnosis and immune system in part to blame for low platelets...and they say that lupus is considered to be 50/50 genetics and environmental exposure. Thanks to Rob and hal and everyone for all the good info here. So much to learn and consider. Sandy Too

Sandy - ITP can be a symptom of Lupus. ITP means low platelets and that's what you have, so I believe that you have ITP secondary to Lupus. I don't know that I'd question that diagnosis since ITP and Lupus often go together.

@Sandy Too : I do not have a rheumatologist, perhaps after more draws I can consider a visit. Just still trying to wrap my head around this whole thing but did manage to get some sleep last night so I am grateful.

Would I definitely have a butterfly rash on my face if lupus was occurring?

No, but you would have other symptoms such as swollen joints, fevers, fatigue, muscle pain, weight loss, nerve damage, etc. I'm not sure what a Rheumatologist would do for you at this point.

I should maybe keep track of my temperature now but I don't think I have fevers as my energy has been ok (which for me is general fatigue ). I do have muscle aches in my calves, quads, arms. I get cold sweats. But no weight loss. I did have the low lymph, low mono, high neut before pred if that might be an indicator of bone marrow damage?

Lupus symptoms widely vary. Did you have those symptoms before Prednisone? Steroids can cause some of those things.

Abnormals on a CBC do not necessarily mean that anything is wrong. Some white cells are affected by allergies, stress, medications, etc...if your doctor isn't worried about it, you don't need to be either.

Thanks Sandi, a place like this is comforting. Really I'm a lot better than I was a couple weeks ago when I was not sleeping and in constant stress about a possible cancer diag. Looking on the internet was the most dangerous thing I could do. At least now with more knowledge I can start to rebuild my life and look online with a more objective fruitful point of view.

Jobs hours have been reduced, but I will no longer be around that chemical except for very breif intervals and I will perhaps look to move onto another line of work.

Prednisone is brutal. It would be hard for me to know the difference between Lupus and high dose pred symptoms right now. I have been on it for over 25 years for Addison's disease. My adrenals quit working. So I am familiar with it. However I have never taken high dose before now, it's rough. I feel for anyone walking into high dose without first knowing the drug. I don't think doctors really ready a patient properly for it. Glad you are feeling better.
My lupus was the last thing to be diagnosed. First hypothyroid at 18, then Addison's at 28, then sjogrens at 40, that's when they started to suspect Lupus too. But the official diagnosis wasn't until after that and I saw a rheumatologist for the first time. My symptoms were always just feeling tired, and achey. The first blood work was quite extensive. Lots of anti-LA, anti-SM, anti-Ro, IgA, IgG,...etc. But the ANA was a false negative, very complicated stuff. Sandy Too

wquine, at a 40 count were you bruising easily ?

I did bruise easily and had gum & nose bleeding. Assuming my count is up next test should I request to start tapering off? I'm begining weekly tests and the pred was not really in my sytem last test. I did not get much sleep last night because my mind was racing and also the muscle aches.

I should say that the gum and nose bleeding were not spontaneous, usually the result of eating apple or rubbing nose...

Ok.
Sorry, haven't been on Pred, can't help you there. The count does look promising so far
Just offhand I would think that if you can get symptoms under control that would be a first goal with treatment. Past that there may be too many different paths to forecast and have to play the cards as you go.

No problem Hal, I'm sure there's plenty of threads about Pred tapering I can read. I have read the FAQs and such but will be back after my next test I do appreciate you all!

Just quick update, I can upload results again but its pretty much the same except my Platelets are at 102 now and I'm weening off the Prednisone now. Praying I can maintain as I ween. Will update further when I have more time. Thanks for the support.

Nice to hear wquine. Sounds like it only took a couple of weeks.

Now right back to 40, that was discouragingly quick drop on the taper. Suggested that I now increase dosage back up to 40 (was down to 20). I certainly don't enjoy the side effects but felt like this was worthwhile, maybe just a case of going on it longer though I'm also tempted to continue taper and start drinking mango leaf tea...

I guess I should at least give it one more go on the Pred. Not all the side effects are bad: my anxiety is almost non-existent though the thoughts are still there my body does not go into fight or flight. Still not sleeping well and broke out on my face(acne), tiny bit of weight gain. I feel more robotic, numb and less creative empathetic. Headaches and dry mouth everyday... Thanks for the support on here just rambling and hopefully someone reading can relate.

Sorry you're counts are back down. It often happens with the taper.

Your withdrawal symptoms sound like mine were. I felt disconnected from my feelings and didn't care about the things I should have cared about. Steroids can also cause depression during a taper; that's another thing to watch out for. I hope you have better luck this time around.

Bummer, but look on the bright side. At the very least you know you can use X dose of prednisone to get counts up to a safe level when needed.

Did your doctor ever mention a 'pulse' of dexamethasone instead of prednisone?

Thanks Sandi & Hal. Disconnected is right Sandi, felt like sometime watching a "numb" movie of myself. Was not as safe a driver either. I have not seen the Hematologist since the initial time but can mention the "pulse" dexamethasone. I will look into it now.

Just an update and moan: 1st day on the Dexamethasone, long day at work, feel horrible. New bruises, constant pains in my legs (feels like constant charlie horse in my thighs and cramp type pains in my calfs), lack of sleep, heachaches, lower abdominal pains, bloating, on and on with other things like weight gain and zits all over my body although those things don't bother me. Sorry for whining, just guess I needed to write that down in case anyone else experiences those effects. The abdominal and deep leg pain I had before steroids. I look these things up online but get nowhere. Just frustrated right now...