Will steroid infusion work for platelet count at 5000?

Question

Hello doctor,

My nephew is 3 years old. He got blood spots on his body, so when we did CBC, we found his Platelets were only 5000. Doctors decided to give him steroids as he was stable. After 48 hours, it came down to 4500. But clinically, he is stable.

So what should we do now? He is in the ICU right now, and doctors are saying he is clinically stable, so giving him steroids.
But how long should we wait to avoid bleeding or other complications?
Can we give IVGG if there is no bleeding? How can we ensure there is no internal bleeding?

Kindly assist.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen the attached report (attachment removed to protect patient identity).

The platelet count is very low. So he is having severe thrombocytopenia. The dengue is negative. So in such a case, it could be an acute immune thrombocytopenic purpura.

He is on the right treatment with steroids. The decision regarding platelet transfusion needs to be taken after clinical examination. If bleeding happens at any time, then a platelet transfusion needs to be given.

USG (ultrasound) or other form of radiological investigation is done if internal bleeding is suspected. You can follow the advice of your hematologist. If steroids are not working, then only immunoglobulin is given, or else no need for it.

I hope he will recover soon.

Revert in case you have any other doubts.

Thank you.