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Decreasing Count Of Platelets, Breathlessness. On Prophylactic Antibiotics. Peripheral Smear Result Yet To Come. Advice
Hlo sir,
M a intern n thr is a patient in medicine ward wit decreasing platlet counts day by day ve reached 0000 today bt she has jst breathlessness as complaint.... Wit no history suggestive of bleedin disorder.... She in on prophylactic antibiotics.... Peripheral smear results yet to cm.....hw to proceed further sir?,??
M a intern n thr is a patient in medicine ward wit decreasing platlet counts day by day ve reached 0000 today bt she has jst breathlessness as complaint.... Wit no history suggestive of bleedin disorder.... She in on prophylactic antibiotics.... Peripheral smear results yet to cm.....hw to proceed further sir?,??
Sat, 17 Aug 2013
Hello and welcome to HCM,
Absence of bleeding with low platelet counts is unlikely.
Look for pre-analytical errors i.e. the collection of blood for platelet counts.
Get the platelet counts done on a fresh sample preferably from a finger prick rather than collect it in anti-coagulant.
Combine it with manual platelet count on peripheral blood smear.
Along with it other platelet indices- PCT and MPV should also be ordered.
All these investigations will help to know the platelet count as well as its function.
Further work up will depend on the results of these investigations.
Platelet transfusion may be required if the counts are very low (
As you have mentioned that your patient is on antibiotics, some antibiotics are known to destroy the platelets.
Check out the list of antibiotics which cause immune destruction of the platelets.
Thanks and take care
Dr Shailja P Wahal
Absence of bleeding with low platelet counts is unlikely.
Look for pre-analytical errors i.e. the collection of blood for platelet counts.
Get the platelet counts done on a fresh sample preferably from a finger prick rather than collect it in anti-coagulant.
Combine it with manual platelet count on peripheral blood smear.
Along with it other platelet indices- PCT and MPV should also be ordered.
All these investigations will help to know the platelet count as well as its function.
Further work up will depend on the results of these investigations.
Platelet transfusion may be required if the counts are very low (
As you have mentioned that your patient is on antibiotics, some antibiotics are known to destroy the platelets.
Check out the list of antibiotics which cause immune destruction of the platelets.
Thanks and take care
Dr Shailja P Wahal
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Hi
Thanks for using Health Care Magic Forum,
: full blood count, liver enzymes, renal function, vitamin B12 levels, folic acid levels, erythrocyte sedimentation rate, and peripheral blood smear.
If the cause for the low platelet count remains unclear, a bone marrow biopsy is usually recommended, to differentiate whether the low platelet count is due to decreased production or peripheral destruction.
Thrombocytopenia in hospitalized alcoholics may be caused by splenomegaly, folate deficiency, and, most frequently, a direct toxic effect of alcohol on production, survival time, and function of platelets. Platelet count begins to rise after 2 to 5 days' abstinence from alcohol. The condition is generally benign, and clinically significant hemorrhage is rare.
Lab tests to determine the platelet count and clotting function may also be done. In severe thrombocytopenia, a bone marrow study can determine the number, size and maturity of the megakaryocytes (the bone marrow cells that release mature platelets). This information may identify ineffective platelet production as the cause of thrombocytopenia and rule out a malignant disease process at the same time.
I Hope I Provided Useful Information. Do ask Furthur Questions to help You get well soon.
Regards
Dr.J.Kingson John David
Thanks for using Health Care Magic Forum,
: full blood count, liver enzymes, renal function, vitamin B12 levels, folic acid levels, erythrocyte sedimentation rate, and peripheral blood smear.
If the cause for the low platelet count remains unclear, a bone marrow biopsy is usually recommended, to differentiate whether the low platelet count is due to decreased production or peripheral destruction.
Thrombocytopenia in hospitalized alcoholics may be caused by splenomegaly, folate deficiency, and, most frequently, a direct toxic effect of alcohol on production, survival time, and function of platelets. Platelet count begins to rise after 2 to 5 days' abstinence from alcohol. The condition is generally benign, and clinically significant hemorrhage is rare.
Lab tests to determine the platelet count and clotting function may also be done. In severe thrombocytopenia, a bone marrow study can determine the number, size and maturity of the megakaryocytes (the bone marrow cells that release mature platelets). This information may identify ineffective platelet production as the cause of thrombocytopenia and rule out a malignant disease process at the same time.
I Hope I Provided Useful Information. Do ask Furthur Questions to help You get well soon.
Regards
Dr.J.Kingson John David
I find this answer helpful
1 Doctor agrees with this answer
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