Check up

My 18 yo daughters platelet count this month is less than 5. I did not realize that LabCorp has a minimum reporting level, although at this point everything revolves around symptoms anyway. Her count six weeks ago was 7. She did have some annoying symptoms this month, occasional post nasal nose bleeding for about 6 days and her period lasted 10 days even on BCP (not heavy, but bleeding and spotting). A lot of bruising and petechiae, but that could really be worse. I held off on teeth cleaning until we saw her count and ended up cancelling it, she will probably need to be treated first. I am a little concerned because she does not have great teeth and I know she can't take good care of them with her gum bleeding.

For now the plan is bloodwork every month and see the hematologist every two months unless anything changes. The doctor calls me with the results and checks in on the labwork only months. With how low her count is she is lucky that any symptoms she has are annoying rather than serious. SO we are basically counting our blessings here.

Hi Terri,

5 is really not a lot. I had 0 before and had similar symptoms, but to me nothing serious happened. I'm still surprised that your doctor does not seem to try any treatment. Or is this a misunderstanding?

When it come to cleaning teeth. When it was not allowed to brush my teeth I took some mouthwash. Medical mouthwash from the pharmacy not the stuff from the supermarket. It felt like it helped.

Good luck for you both!

Cheers,
Joerg

Hi Joerg,

My 18 yo daughters platelets are less than 5 (not sure of the exact number). She is currently on watchful waiting. The pediatric hematology group who treats her feels you should treat the child and their symptoms verses treating a number. We consider it very fortunate that with how low her platelet count is her symptoms are more annoying than serious. She did have one course of IVIG when her count dropped under 10, her count went up to 45 but rapidly dropped below 10 again. She had bad headaches for 2 days afterward. They gave her the IVIG basically to treat her heavy periods until BCP could kick in and to make sure they would have a way to treat her in an emergency. The doctors feel that since her ITP is chronic (although her counts have only been this low for about 6 months) she could be facing a long haul and all the treatments have side effects, so only start treatment if the symptoms require it. And they always ask how her symptoms impact her lifestyle. The low numbers were a little frightening to me at first, but I am really glad that this is the approach they advocate.

Last month Sandi posted an article on Treating ITP in Children, this is the approach that Childrens Hospital of Philadelphia also seems to use.