2 1/2 year old diagnosed in November

My son was diagnosed with ITP in November after I noticed petechiae behind his knees. At the time of diagnosis his platelets were down to 4,000 so he was admitted and given IVIG for treatment. The doctors said they were confident it was ITP because the rest of his CBC was normal. Since then he has been getting his blood checked once a month. The first test was normal and his platelets were up to 162,000, but the last three have slowly become more and more abnormal. His platelets are beginning to drop again, roughly hovering around 75,000-105,000, so not a huge concern at this point. My concern is that other things are showing as abnormal and I was wondering if any other parents had seen this happen with their children's CBC results. I feel totally frustrated because he doesn't typically show the signs of low platelets; such as, petechiae, bruising, bleeding, etc. I am also frustrated because I was initially told that ITP only caused low platelets, but other counts are showing low or high for their range. I was hoping someone could look at his CBC results from yesterday and tell me if I should be concerned that there may be another problem here, or if I'm overreacting. Thank you in advance for your time.

WBC 9.3
RBC 4.71
HGB 12.5
HCT 33.5 L
MCV 71.1 L
MCH 26.5
MCHC 37.3 H
RDW 12.4
PLT 104 L
Seg. Neut. 22 L
Lymphocytes 73 H

The treatments can sometimes affect the other counts. Most people with ITP find that they do not have totally "normal" CBC's. A slight high or low is fine; the reference range is only that, a range in which most people fall. Going out of that range does not mean there is anything else wrong with him. Have his doctors said anything?

The fact that he doesn't have typical ITP symptoms doesn't mean anything. Some children just don't have a lot of bruising and that is actually a good thing. If he had low platelets for another reason, he probably would have more bleeding and bruising. People with ITP tend to have less symptoms because they have nice, large platelets which work quite well. While that is not true for all ITP patients, it certainly fits a lot of people.

nasmc08 wrote: My son was diagnosed with ITP in November after I noticed petechiae behind his knees. At the time of diagnosis his platelets were down to 4,000 so he was admitted and given IVIG for treatment. The doctors said they were confident it was ITP because the rest of his CBC was normal. Since then he has been getting his blood checked once a month. The first test was normal and his platelets were up to 162,000, but the last three have slowly become more and more abnormal. His platelets are beginning to drop again, roughly hovering around 75,000-105,000, so not a huge concern at this point. My concern is that other things are showing as abnormal and I was wondering if any other parents had seen this happen with their children's CBC results. I feel totally frustrated because he doesn't typically show the signs of low platelets; such as, petechiae, bruising, bleeding, etc. I am also frustrated because I was initially told that ITP only caused low platelets, but other counts are showing low or high for their range. I was hoping someone could look at his CBC results from yesterday and tell me if I should be concerned that there may be another problem here, or if I'm overreacting. Thank you in advance for your time.

WBC 9.3
RBC 4.71
HGB 12.5
HCT 33.5 L
MCV 71.1 L
MCH 26.5
MCHC 37.3 H
RDW 12.4
PLT 104 L
Seg. Neut. 22 L
Lymphocytes 73 H

The IVIG can skew some of the results. His lymphocytes being up is very indicative of his body fighting something (which can either be the IVIG as it "distracts" the body from the platelets) or it's also indicative of an autoimmune situation (which ITP is). We did not see lymphocytes finally go normal until the IVIG left my son's body (about 5 months AFTER he had his last IVIG). So for now, this really does not look worrisome to me. It's always a good idea to keep lab work as data points as time goes on. But for now, I wouldn't worry too much about how this looks.


hth

patti

Thank you very much for the replies. He had IVIG in November, and the doctors told us it would stay in his system for about 6 weeks, so that would be a fitting reason as to why his whites are slightly elevated. I'm just hoping we can go in and see everything falling back into place soon. 2 more weeks until his next tests.. prayers and fingers crossed!

nasmc08 wrote: Thank you very much for the replies. He had IVIG in November, and the doctors told us it would stay in his system for about 6 weeks, so that would be a fitting reason as to why his whites are slightly elevated. I'm just hoping we can go in and see everything falling back into place soon. 2 more weeks until his next tests.. prayers and fingers crossed!

It may stay in the blood stream for 6 weeks but I can guarantee you after watching our boy, that it doesn't leave the body cells till long after that. It finally left my boy's body after 5 months. It didn't do us any favors hanging in his body like that.