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483 sounds terribly high after 7 days. Did they start out at the lowest dose, a '1' mg per kg dose?Mumofjess wrote:
...
On August 7, with the return of the nosebleeds and some petechiae and blood blisters in her mouth and a platelet count of 4, it was decided that she be given an NPlate injection to get her out of this critical state that she was in. She had not responded well to IVIG, steroids or a combination of both and was still have significant bleeding issues. A 5 day 1/2 dose of Prednisone started on the same day as the NPlate injection. She had been on tranexamic acid since day 1 as well.
3 days post NPlate, her counts were at 110 and no bleeding, white blood cells were elevated. 7 days post NPlate and her platelets are at 483!! Her white blood cells are still elevated and red blood cells and hemoglobin remain low. The prednisone is done and we also stopped tranexamic acid.
AFAIK, when there is bleeding, like mouth blisters, administering drugs like Nplate or Promacta for those above one year of age would be typical.We go for a CBC on August 21 and I am terrified as I have no idea what to expect. Has anyone had a child receive NPlate this early on the diagnosis? If so, or even if later, how has your child responded?
Nplate takes about a week to fade away and counts begin to drop. Hence the reason why it is given once a week.Have the counts dropped significantly?
From what I've seen around here, headaches from Nplate can be from the drug itself, or, from high(er) counts. That is, some folks can have headaches with lower Nplate doses.Has anyone had the low hemoglobin and red blood cells with high white blood cells as well. She is experiencing mild headaches and some bone pain from the NPlate.
Try not to worry. Some of the worse sounding ITP journeys end up with remission. I would expect the current goal would be to prevent bleeding and give the immune system time to sort out things. Get self versus non-self detection of platelets correct again.If her count is 50 or higher, she will not have another injection on the 21st. We will wait and observe.
I'm looking for anyone with a similar journey as my daughter. I have read through a lot of the discussion and have not found another post about a child initially presenting with significant bleeding. I look forward to hopefully hearing from someone travelling a similar path. Thank you.
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