7 year old daughter diagnosed with ITP

Hello Everyone,
On 7/5/14 my 7 year old daughter went for routine blood work following her yearly physical. The morning of 7/6/14 we received a call from the DR that her platelets count was at 4,000 and to get her to the ER. The blood work done in the ER showed her platelet count at 0. She was admitted to the PICU and given a round of IVIG over night. Her platelets count on 7/7 was 28,000. She was then given another round of IVIG and her count on 7/8 was at 58,000 so she was discharged. Follow up blood work on 7/10 was 106,000. We followed up with the Hematologist and he believed we were in the clear. Blood work from the hospital showed that she had the Coxsackie virus so he believed that is what caused the ITP. Her ANA blood work came back positive so he wanted her to have CBC and DS-DNA blood work done on 7/18. Well the morning of 7/19, the DR called that her count was back down to 4,000 and back to the hospital we went. She has another 2 rounds of IVIG and on 7/21 her count was at 71,000. Are recurrences so close together normal? We aren't getting many answers from the DR and will be looking into a 2nd opinion as well. Her pediatrician said if the numbers go down a 3rd time we should see about having her bone marrow checked.

IVIG isn't a cure, its just a temporary sticking plaster. It usually only lasts between about one and three weeks, so what has happened with your daughter is pretty typical. It sounds like she doesn't have too many symptoms which is good news. If this is the case, then not treating her at all is actually an option. I hope she recovers soon.

Be sure to get a good Hematologist. A bone marrow biopsy may be premature at this point. It's not necessary to have the bone marrow tested just because counts keep going down after IVIG. As Alison said, it is only a temporary treatment and does not last. Many pediatricians are not familiar with ITP and tend to panic a bit.

Do you know what the titer (result) of the ANA is? Just saying it was positive doesn't mean much; a slight elevation is nothing to worry about but a higher elevation could be.