Elevated Factor 8 and ITP

It's been awhile since I've been on here, so here's a quick update :

My counts have slowly gone up. It is now not unusual for me to be in the "normal" range. Which is great! But I do have dips at least once or twice or month. Twice now I've had dips and sudden increases. In one week I went from 33,000 to 264,000!! Two weeks ago I went on a Thursday and had 40,000. I went again Monday due to an upcoming procedure I needed higher counts for. I was 118,000. Then I was 168,000 three days later.

So these fluctuations concern me because they're so fast! But I notice drops only stay for a couple days. And I've tracked the dips to my ovulation and menstrual cycle. So that is something I'm still tracking to take to my doctor.

They just did the APS tests and others for clotting disorders, since my hormones are getting back to normal from having a baby/breastfeeding. Everything is normal except I have an elevated Factor 8. This really concerns me. Anyone else have this? The nurse couldn't give me any info on it. So I'm looking for anything you have on this! Thanks!!

Sorry, Taz. I don't know anything about it. It's odd how many people with ITP also have clotting problems. I also read an article once in Blood Journal that stated that there is a theory that the body lowers platelets on purpose to compensate for the clotting risk. That was interesting.

Thank you, Sandi! Hopefully someone has some info. I'll keep digging as well!

Taz,

You have had these fluctuating counts for a long time. Is it possible the lows are false readings? (pseudothrombocytopenia).

Or, could it be that there is something you eat, drink, etc. that could be causing the lows? I recently found a case of thrombocytopenia triggered by an ingredient in root beer (quillaia) which is also present in quinoa (not suggesting that is it in your case, only suggesting it could be anything).

Regarding Factor VIII:

There can be an association between elevated Factor VIII and diabetes.

Have you taken any steroids? This article says that steroids elevate Factor VIII, increasing risk of thrombosis.

cat.sagepub.com/content/19/6/613.short
Arterial and Venous Thromboses in Patients With Idiopathic (Immunological) Thrombocytopenia
A Possible Contributing Role of Cortisone-Induced Hypercoagulable State

Abstract

Immunological thrombocytopenias, as other forms of thrombocytopenia, are associated with bleeding. Occasionally, these patients manifest thrombotic events. A total of at least 29 patients were reported to have had either arterial (20 cases) or venous (9 cases) thrombosis while platelet count was less than 50 × 103/μL. The most frequent clinical manifestation was a myocardial infarction. Thrombosis occurred in the large majority of patients during prednisone therapy. Patients receiving cortisone or patients with Cushing syndrome show a hypercoagulable state characterized by elevated factor VIII levels, decreased fibrinolysis, and abnormal von Willebrand factor multimers composition. The same is probably true for prednisone-treated patients with thrombocytopenia. However, the 2 conditions are not identical since prednisone is a mainly glycoactive compound, whereas cortisol produced in excess in Cushing syndrome is mainly mineraloactive. The presence of large, young, hyperactive platelets may also play a role. Prednisone-treated patients with thrombocytopenia have to be considered as potentially thrombophilic.

Thank you, Rob! I have never had treatment. My lowest count has been 30,000. My counts have fluctuated a lot. But they were steady in the 30s for many months and then slowly started to rise before the fluctuations started. So I don't know what to think!!

The only thing I have really found on Factor 8, is that it can change as well. I'm not sure how frequently. And I don't know if I've been tested for it before. I will have to ask more questions.

Sandi, your comment has me wondering how many of us with ITP also have a higher risk for blood clots? I mean, how many have had some sort of bloodwork that shows this? And what can we do to try and prevent them? I need to talk more to my doctor, obviously, but I'm curious what others do or have done.

Most people have a greater risk of blood clots due to platelet microparticles or Antiphospholipid Syndrome. I have had APS antibodies.

Here is a video that talks about ITP and thrombotic risk:

www.onclive.com/insights/immune-thrombocytopenia/Risk-of-Thrombosis-in-Patients-With-ITP

Researchers in Spain measured and tested the clotting potential of microparticles (very small bits cells) in the blood of people with ITP and found that the microparticles in these patients were more prone to form blood clots than the microparticles in the control population. This was also true of those ITP patients who had a splenectomy and were in remission. The clotting potential of microparticles may be helpful in preventing bleeding, but this condition may also make people with ITP more prone to heart attacks, strokes, and clots in their veins than might be expected.

#3707 “Increased Microparticle-Linked Procoagulant Activity In Patients with Primary Immune Thrombocytopenia”

www.pdsa.org/products-a-publications/e-news/2010-e-news/item/405-platelet-e-news-december-21-2010.html#INCREASED_MICROPARTICLES_LINKED_TO_THROMBOSIS_IN_ITP

Thank you, Sandi. Of course, I am not the typical case with ITP, or now with the factor 8 levels... as this whole journey has proven. Ha ha. I know everyone is different, but I feel my story is way different than the majority of others. It is hard to make sense of it all or know what to do sometimes when I feel so different.

Rob, I like your pseudothrombocytopenia theory, but I don't think that's the case here. My blood smear was typical ITP and I get symptoms when I drop below 50. They may be vague, since they don't stay down long, but I notice them. Unless I don't fully understand pseudothrombocytopenia, which may very well be the case, then I think it's unlikely. And I wish I could tell if anything I was eating or drinking caused it. Wouldn't that be a great find! I find that task impossible at the moment

Thank you both for all of your help!