Hello and thanks for the query.

Your question is a good one and often difficult to understand so I will try to provide you with some more information and recommendations regarding what is going on.

First of all I would like you to provide a copy of your recent blood tests including complete blood count, peripheral smear analysis as well as any additional antibody testing which may have been performed. If a bone marrow analysis was done these results may be useful also. This will help me provide good recommendatsions for you.

I would say the most likely contributing factor to this is what we know as immune thrombocytopenic purpura. This is a process by which the immune system causes a chronic mild destruction of the platelets which depresses the total platelet count. This is generally followed over time and at some point treatment may be necessary.

Having a low platelet count while concerning is not necessarily XXXXXXX For example, in my practice I do not worry about patients having bleeding concerns until platelets are in the 5000 to 7000 range. Your platelets being near 70,000 is reassuring along those lines.

So I will await the additional input from you and you can send this to my attention at YYYY@YYYY . I will review the data and then get back to you with further discussion.

I am sure this has caused you some anxiety and let me reassure you that you are not dealing with a life-threatening issue and often this condition can be monitored and controlled without disturbing quality of length of life.

Again I thank you for your query. I hope this will serve as a useful exchange for you.

Sincerely,

Dr. Galamaga

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Hello and thanks for the query.

It seems from everything that you submitted that your doctors have done a fine job at investigating for any underlying cause of the low platelets.

No infectious cause has been identified and it not likely playing a role. The bone marrow biopsy did not show any abnormal appearing cells or any evidence of leukemia.

With all of these investigations now completed you certainly do seem to have a case of ITP or immune thrombocytopenic purpura.

This is a process of no real known cause but we do understand that there are antibodies generated by your immune system which destroy some of your platelets which depresses your overall platelet count. At this point I think you can be followed by your hematologist with interval blood count checks at the lab.

Let me give you a link to a couple of websites with good information to help you understand the ITP.

1) WWW.WWWW.WW
2) WWW.WWWW.WW
Please review these two websites for more comprehensive information.

Lastly I did notice that your total protein level is slightly elevated. In order to make sure there are no abnormal proteins in the blood I recommend your doctor consider doing an SPEP or serum protein electrophoresis which can clearly identify if there are any abnormal proteins.

I thank you again for your query. I also thank you for submitting all of the information which I was able to review regarding your case. If you have additional concerns please do not hesitate to ask.

Regards,

Dr. Galamaga

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