What Causes Fall Of Platelets Inspite Of Taking Continuous Steroids?

Mitalee jain was admitted with platelet count 9000 and complaints of purpuric spots/excessive bleeding.PV during mentrual period since one week.The blood counts showed anemia,severe thromcytopenia and nueutrophlic leucocytosis.During hospitalisation she was transfussed frozen platelets,developed reaction and was shifted to icu for one day and later shifted back.During the stay injection dexa was given,her platelets improved.Bone marrow aspirate showed f/o ITP.Her DCT and ANA were negative.At the time of discharge her platelet was 1 lac.

wysolone - 40mg

pantocid - 40mg

shelcal - 500 mg

tab D3 0.25mg

The above tablets were tapered down slowly and stopped by Aug 2010 end.Again on 13th September platelet came down to 38000.Injection dexa 40mg was given.

On 24th oct platelet came down to 12000,haemoglobin 12.2 and wbc 7100.She was given dexa(high dose) for 4 days followed by oral wysolone - 60mg/day and was discharged in 4 days with platelet count 1 lac.

The above steriods were continued and tapered down to 5 mg alternative.In Nov along with the steriods dapsone 100mg was started and is continued.Again in Feb platelet came down to 19000.Again dexa 40mg was given.





12/12/10

haemoglobin - 11.1

wbc - 13800

platelet - 2.96





9/1/11

haemoglobin - 10.9

wbc - 11700

platelet - 2.67





16/2/11

haemoglobin - 10.8

wbc - 8600

platelet - 0.81





25/2/11

haemoglobin - 11.7

wbc - 6700

platelet - 0.19