Anyone with experience of hospital acquired anemia

Hi, I am new to here. My son is not diagnosed with ITP, yet. He is 7 year old, and recently had 2 heavy nose bleeding. So I asked our pediatrics and had his blood tested. His platelet count was low, 15K and then 26K next week, hemoglobin was low but not extremely low (10.4 and 11.7). The day before the second test, he had a fever, his white blood count was 2.x so they admitted him to hospital. Leukemia, aplastic anemia, faconi anemia were tested and ruled out. Now we are waiting for the genetic test result to find whether there are any gene problem.

While waiting, he has 2 doctor visit every week, each time at least 3 tubes (3ml each) blood drawn, sometimes 5 or 6 tubes for more test. His hemoglobin was dropping slowly since he admitted to hospital one month ago, and every time more tubes drawn, the number drops more. I checked online, there are some guideline for safely remove blood from patient, and his volume exceeds every hospital standard for his weight I can find. I talked to the doctor, and he said this is not a problem...

His platelet count is still low, around 15K for all the tests except for a week after a platelet transfusion. I think platelet is the main problem (that's why I am reading this website), and hemoglobin is low because of the nose bleedings (each last half day) and frequent blood test. Doctor thinks he has platelet and red blood cell problem.

Is there anyone else have similar experience? Thanks.

I don't know that being in the hospital would have anything to do with acquiring anemia. It's probably a coincidence. If he has both a platelet problem and a red blood cell problem, he could have Evans Syndrome. There are tests for that. Profuse bleeding can cause anemia though so hopefully that is the cause.

His doctor said his platelet slowly dropped over the week after transfusion, so it is not immune system attacking platelet. If it is immune system, the platelet count would have dropped right after the transfusion. So they are focusing on bone marrow failure.

I just checked, Evans syndrome is a also diagnosis of exclusion like ITP. I will ask Doctor during next visit.

Thanks.

About hospital acquired anemia, I checked online articles from nih and medscape and other websites, about 20% patients developed anemia while in hospital, and the risk increases 18% with every 50ml blood drawn (adult).

Was the transfusion the only treatment that he had while in the hospital? No IVIG or steroids? He'd need a bone marrow biopsy to determine bone marrow failure. You can't rely on what happens after a transfusion.

Yes, the transfusion is actually not a treatment, it is for preparing the bone marrow biopsy. Because his count was 15, they think it is dangerous to go through the procedure. Bone marrow was not abnormal, at least at that time (one month ago), was not leukemia and aplastic anemia. Doctor didn't give him any other treatment because we don't know the cause yet.

I am kind of "hoping" the anemia was caused by blood tests because red cell count was ok before they start to monitor him...