Finger Stick for Count

Hello....I am new to the board. My 18 month old daughter was diagnosed with ITP last week. She needs weekly blood draws every week for a month until she goes back to the doctors. I am a little concerned about the count we got last night because it was so high and it was done with a finger prick (after they missed 2 veins) and it took a really long time. The nurse was concerned that the sample may have alreay started clotting.

Here are her numbers

03/15/10 21,000
03/16/10 17,000 (Hospital - no treatment)
03/18/10 88,000
03/25/10 877,000

Now her platelets are extremely high, all with no treatment. Does this seem normal????

Don't really know but it doesn't sound impossible. My son always has thumb pricks for counts even at the Children's hospital and they seem to think they are very reliable

Up is a good sign though I would say.

Ali

That's a very high number. It wouldn't hurt to get another stick to double check. I wouldn't think that the number would be that far off, though...by hundreds of thousands. It is considered more accurate to get a draw rather the prick though. Did they say why she is so high?

The doctor sent us for another count today because she was sure the 877,ooo was an error. Her number today was 733,oo0, so I'm guessing the count last night was accurate. Does anyone know what can make your platelets go from extremely low to extremely high in one week, with no treatment. Now I have the weekend to worry that something other than ITP is at play.

What has the doctor said?

We did not see the doctor. We just went to the local hospital for a blood draw.

I certainly don't mean to alarm you, but I think that it is VERY STRANGE that your daughter would jump from such a low number to such a high number with no treatment. Have you been doctoing with a GP or a specialist (hematologist).

The finger prick and a draw from a vein can be different, just because the draw from the vein gets more blood, but there is no way that it can differ by hundreds of thousands.

The sample should not clot, as there is an anticoagulant in the tube that they use to collect the blood.

I am very interested to see what happens next with you and your daughter.

Michelle - mom to Danica

I agree with Michelle, she should see a hematologist to assess the cause of this jump. That's a very high count in such a short time.

My daughter's counts did something similar back in 2004 when she was first diagnosed with ITP. She was 11 at the time. They were
7/15/04 18,000 (she was very sick with fever, etc)
7/17/04 7,000 (hospitalized but not treated) monospot test with false positive diverted doctors from treating for tick disease
7/17/04 10,000
7/17/04 13,000
7/18/04 22,000 fever resolved for a few weeks
7/19/04 72,000
7/26/04 625,000
8/2/04 16,000 (fever, headache)
8/3/04 3,000 (hospitalized, given IViG) ehrlichiosis retest just came back from lab, confirmed positive


By 8/2/04 we finally got a positive result for ehrlichiosis, which was what we first suspected back in mid July but the blood for the test was diverted to a monospot test by hematologist which was a false positive for her and the doctors were all distracted by that. She was 11 at the time. After she was treated with antibiotics for the ehrlichiosis, her platelets were fine for several years. Gradually it has become so that any cold or virus can make her platelets plummet to below 10- 30K, but otherwise her platelet counts are very stably normal.

Technically she has chronic ITP because it has been almost six years since the first episode and it recurs but I call it recurrent acute because counts are usually around 300K when stable. She usually doesn't need treatment if the trigger (virus, tick disease, etc) resolves quickly enough. Her version of ITP seems pretty unusual on this discussion forum since her counts are so normal if not sick.

More recent #s
5/24/08 29,000
5/31/08 132000
6/7/08 472,000

10/7/09 20,000
10/12/09 269000 (no treatment)

I've noticed that when her body goes crazy making platelets it completely exhausts her. Think the body's control systems go a bit overboard in making platelets, but soon stabilizes. Seemed that the trigger still being present fighting a war in the body caused the platelet level control system to be out of wack during the ehrlichiosis episode when it went untreated for so long.

I only had finger sticks every now and then when i was younger if they tried a few times and couldn't get blood. I was told it's not a good way to take blood for a FBC, not sure if it was just because it takes longer to get blood out of the tiny hole the needle has made and the needle doesn't stay in the vein for the duration of it or was something to do the results not being as reliable. I'd speak to a Doctor about it though, it does seem a little worrying they have fallen and risen so high so quick without treatment.