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Have not been diagnosed yet, but is it possible i

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8 years 9 months ago #57669 by Neti
Have not been diagnosed yet, but is it possible i was created by Neti
Hello all! I have been having low platelets for a while now, usually in the 60 or 70's, 4 months ago, it went down to 14, my hematologist did a bone marrow biopsy, came back normal,started on prednisone, my platelets stayed between 50 and 60, they weaned me off, I would have blood test every 2 weeks, a few days ago my platelets were 70, took my last pill still 70, they sent my labs to the main hospital and it came back as 8, the doctor there called me after hours and told me to go back to my doctor to get another reading,this time it came back as 6, they sent another sample from the same tube to the hospital and came back as 10, my doctor said she is totally flabbagasted and put me back on 40 mg of prednisone,is this normal for people with ITP,they have never even mentioned that, should I mention it to them? Thank you
  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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8 years 9 months ago #57670 by Sandi
Replied by Sandi on topic Have not been diagnosed yet, but is it possible i
Hi. Are you saying that the same blood sample read as 70 and 8 or was there some time between the two counts?
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8 years 9 months ago #57691 by hollygirl05
Replied by hollygirl05 on topic Have not been diagnosed yet, but is it possible i
Hi, they took my blood at the doctors office, it read in the 70's, then sent it to the hospital for better testing, came back 8, the next day, went back for another sample and the doctors office came back 6, sent it to the hospital again, then it came back as 10. I was off prednisome for 2 days, now back on 40 mg, when I was on prednisone, my numbers stayed between 50-70.
  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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8 years 9 months ago #57692 by Sandi
Replied by Sandi on topic Have not been diagnosed yet, but is it possible i
Two possible explanations. One, platelet clumping. If that is the case, the one done at their office right away should be more accurate. Two, pseudothrombocytopenia. I'd bet more on No. 1.
Either that or their analyzer is way off base.
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8 years 9 months ago #57758 by Rob16
Replied by Rob16 on topic Have not been diagnosed yet, but is it possible i
Sandi, I thought pseudothrombocytopenia was the same as platelet clumping. Did you write what you meant to say, or am I confused?
  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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8 years 9 months ago #57759 by mrsb04
Replied by mrsb04 on topic Have not been diagnosed yet, but is it possible i
www.bloodjournal.org/content/117/16/4168?sso-checked=true

Good definition here
  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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8 years 9 months ago #57760 by Sandi
Replied by Sandi on topic Have not been diagnosed yet, but is it possible i
It's not quite the same thing. I've had platelet clumping many times, but did not have Pseudothrombocytopenia. Pseudo involves clumping, but there are other criteria that need to be met. It can be hard to diagnose. I've seen a few people here being treated for ITP (low counts) for months only to find out that they had Pseudo.

Ethylenediaminetetra-acetic acid (EDTA) is widely used as anticoagulant in laboratory medicine. EDTA-dependent pseudothrombocytopenia is a rare phenomenon (i.e., around 0.1% in the general population), which is mostly due to the presence of EDTA-dependent antiplatelet antibodies that react optimally between 0°C and 4°C, recognize the cytoadhesive receptors gpIIb-IIIa, stimulate the expression of activation antigens, trigger activation of tyrosine kinase, platelet agglutination and clumping in vitro, which finally lead to a spuriously decreased platelet count. The reliable and timely identification of this artifact is essential, since there a high chance that it may be confused with other life-threatening platelet disorders, or otherwise lead to inappropriate clinical and therapeutic decision-making. Five basic criteria should be fulfilled to raise the clinical suspicion of EDTA-dependent pseudothrombocytopenia, i.e., (i) abnormal platelet count, typically <100×10(9)/L; (ii) occurrence of thrombocytopenia in EDTA-anticoagulated samples at room temperature, but to a much lesser extent in samples collected with other anticoagulants and/or kept warmed at ~37°C; (iii) time-dependent fall of platelet count in the EDTA specimen; (iv) evidence of platelet aggregates and clumps in EDTA-anticoagulated samples with either automated cell counting or microscopic analysis; (v) lack of signs or symptoms of platelet disorders. Several remedies have been proposed, such as warming the sample to 37°C or using additives or specific formulations of anticoagulants including buffered sodium citrate, heparin, ammonium oxalate, β-hydroxyethyltheophylline, sodium fluoride, CPT (trisodium citrate, pyridoxal 5'-phosphate and Tris), antiplatelet agents, potassium azide, amikacin, kanamycin or other aminoglycosides, and calcium replacement with the simultaneous addition of calcium chloride/heparin. According to available evidences, the most suitable and practical approach so far for most clinical laboratories seems, however, the recollection of blood samples using sodium citrate, CPT or calcium chloride/heparin as additives, maintaining the specimen at 37°C until the platelet count has been completed.

www.ncbi.nlm.nih.gov/pubmed/22868791/
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8 years 9 months ago #57782 by hollygirl05
Replied by hollygirl05 on topic Have not been diagnosed yet, but is it possible i
Hi, when I'm put back on prednisone, platelets went back up
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8 years 9 months ago #57783 by hollygirl05
Replied by hollygirl05 on topic Have not been diagnosed yet, but is it possible i
It was 2 different tubes, purple top and another tube that keeps blood from clotting, hospital is walking distance from my doctors office
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