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Platelet crash within 13 days of splenectomy 3 months 2 weeks ago #73379

  • Badami
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  • Parent of a child with itp for 8 years . No platelet stability Post splenectomy
  • Posts: 53
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My son 26 now was diagnosed with itp 7years ago.
Various medicines like ivig ,dapsone, mmf ,steroids , mmf and revolade and romiplostim etc did not stabilise his counts and they kept fluctuating for 7 years. Dr. Finally suggested a splenectomy and post surgery within 3 days platelet count was 12lakhs .
In 14 days they have crashed to 4000.

Does anyone have any clue why this could happen ?
Now what are the options left? 

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Platelet crash within 13 days of splenectomy 3 months 2 weeks ago #73380

  • 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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Badami
So sorry to hear this news. Unfortunately there is no guarantee that a splenectomy will work. Has your son tried Avatrombopag? 
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Platelet crash within 13 days of splenectomy 3 months 2 weeks ago #73381

  • MelA
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As mrsb be mentioned, there is no guarantee a splenectomy will "cure".   From what I was told our bodies continue to make the antibodies that attach themselves to the platelets.   I've sorry the splenectomy did not work for your son!  Hopefully his body will adjust and get that count to a decent level!
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD
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Platelet crash within 13 days of splenectomy 2 months 1 week ago #73437

  • Badami
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  • Parent of a child with itp for 8 years . No platelet stability Post splenectomy
  • Posts: 53
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After 2 rounds of ivig+ dexameth+ revolade the platelets increased substantially to 1 million

Then Doc put him on only revolade (50) per day

However the crash is also rapid 
My son's platelets are decreasing by 200000 platelets  a day.

I have no idea how  the spurt to a million platelets  and subsequently why the rapid crash.? 
 Prior to splenectomy  I never saw his platelets go above
150000

Any advice or answers? 

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