Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hi doctor,
My wife is on routine ANC investigation and got to know she has Thrombocytopenia 38 thousand platelets. She is eight months pregnant. Then, on the physician's advice, the MP and dengue test was done.
When CBC was repeated, platelets were reduced to 25 thousand. As I was worried about the child, we went through 8 units of platelet transfusion under the guidance of a doctor. After an 8-unit transfusion, platelets rise to 43 thousand. Today, platelets are 45 thousand. Now, she is discharged, and a Carica Papaya syrup is prescribed. The doctor asked us to wait and watch. We will repeat the complete blood count after three days. My wife is normal throughout the day. There are no signs and symptoms of bleeding, rashes, and fever except cough from the last night due to air condition. I want your help. Should I wait or go for a second opinion?
I fear it is due to dengue, pathological or physiological (pregnancy). Immunological thrombocytopenia (ITP)
, or Isolated thrombocytopenia.
What should I do?
Thank you.
Hi,
Welcome to icliniq.com.
Let me give you my opinion regarding your wife's condition.
She is now stable, and no further management is needed if no active bleeding is present. Just take the prescribed syrup and drink lots of water. It is a case of dengue infection.
In gestational thrombocytopenia, platelet count usually does not decrease to less than 60000. In immune thrombocytopenic purpura (ITP), the platelet count is usually less for many months, at least six months, and the previous count is also abnormal in such cases. ITP is suspected if no other causes of secondary thrombocytopenia are present.
So here, dengue can be the most common possibility, and in dengue at the middle stage of the disease, platelet decreases to a low level, fluid is given in such cases, and Symptomatic management is done. If active bleeding is present, then platelet transfusion is needed. Repeat CBC after three days. Until then, take the prescribed syrup and rest.
If the cough increases, then Auscultation should be done.
I hope this will help you.
Thank you.
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Pathology
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