Can you help with my daughter's low platelet count?

Question

Hi doctor,

My 12-year-old daughter was fatigued and had blue blotches over her body. The doctor locally ordered blood tests, and the results showed a low platelet count of 50000. They administered Cortisone of 30 mg a day for two weeks, and the count went up to 100000. The doctor reduced Cortisone to 15 g a day. She felt fatigued again, and when we conducted the test, the platelet went back down to 50000. They have no answers.

Can you help?

Answer 1

Hi,

Welcome to icliniq.com.

Your child is having a low platelet count and blue blotches over the body. The skin discoloration can be from low platelets, as thrombocytopenia can lead to mucosal bleeding.
If cyanotic patches seem to be present on examination, then cardiac, respiratory, and vascular causes need to be searched for.
In your child, the low platelet could be commonly due to immune thrombocytopenic purpura. Other causes include chronic infection, blood septicemia, uremia, TTP (thrombotic thrombocytopenic purpura), drugs, etc.
According to the examination, further workup will be planned, like if needed to confirm ITP, then do a bone marrow examination study.
As with steroids, the count improved previously. So, it seems most likely to be ITP. For ITP, steroid and intravenous immunoglobulin are the mainstay therapies with or without platelet transfusion.
Consult a nearby physician or hematologist for examination and accordingly plan the management.

I hope this helps.