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TOPIC: Not sure what to think. Is the hematologist wrong?

Not sure what to think. Is the hematologist wrong? 1 year 9 months ago #59767

  • leahdyanne
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A a few months back I went in for my annual physical with my PA. Tests came back that I had a low platelet count of 120,000. He was concerned enough to send me to a hematologist. Okay. So three weeks later I had another blood test when I went to the hematologists' office. I was down to 106,000. They did an ultrasound a couple weeks later and it came back showing nothing significant. No enlarged spleen, nothing. And my blood work showed at the same level.

Here's the thing: I get tired easily. But no anemia presented. Red and White cells were fine. So the hematologist wants to see me back in 3 months. But isn't this like, pretty dang low platelet count? I bruise easily for reasons that, well for no reasons. I had to stop working out my legs at the gym because, when I used the leg machines, I hematoma'd all over the backs of my legs. I looked like someone had stomped me.

Anyway he sent me back to my PA and told me to tell him to consider a thyroid test (because I said I'm hungry all the time as well).

Any ideas? Is this normal procedure? Or should we be looking elsewhere for a hematologist?

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Not sure what to think. Is the hematologist wrong? 1 year 9 months ago #59768

  • CindyL
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Welcome, leah.
106,000 is a good number. I too bruised easily. When I was diagnosed, I was at 47. It could be a good idea to have your thyroid checked, it may explain the tiredness. Some doctors don't agree that fatigue is a symptom.
In my opinion, have your thyroid checked and see your hema in the 3 months he suggests.
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Not sure what to think. Is the hematologist wrong? 1 year 9 months ago #59774

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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Leah, 106 is not a low count. It's lower than normal in the reference range, but not low enough to treat. Any hematologist would simply monitor you at this point; treatment is not usually started until a patient hits 20k or 30k. Treatments can have nasty side effects so you don't want to do that unless you have to. As for the fatigue, it wouldn't hurt to look into other causes like thyroid or vitamin deficiencies.
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Not sure what to think. Is the hematologist wrong? 1 year 9 months ago #59786

  • leahdyanne
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Thanks so much. It seems really crazy but if this is what you all who are experienced with this say, I feel confident with that. I've been having lots of digestive issues but the hematologist says all of my internal organs do look good. Guess there's something good came from those tests!! :)

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Not sure what to think. Is the hematologist wrong? 1 year 9 months ago #59787

  • leahdyanne
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Thank you so much. It was kinda scary when they first started talking about this.

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Not sure what to think. Is the hematologist wrong? 1 year 9 months ago #59793

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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:) Yes, trust me, your count is not low. Monitoring is all you need right now, but be aware that counts can drop and in that case, you'd want to watch for gum or nose bleeding, spontaneous bruises, petechiae, purpura, heavy menses, blood in urine, etc. If that happens, just call your PA and ask if you can get a CBC. It's not cause to panic. Platelet counts fluctuate constantly, so your counts could just as easily go back up to normal in the next few weeks or months.

Primary immune thrombocytopenia (ITP) is an acquired immune-mediated disorder characterized by isolated thrombocytopenia, defined as a peripheral blood platelet count less than 100 × 109/L, and the absence of any obvious initiating and/or underlying cause of the thrombocytopenia.

A presumptive diagnosis of ITP is made when the history, physical examination, complete blood count, and examination of the peripheral blood smear do not suggest other etiologies for the thrombocytopenia. There is no “gold standard” test that can reliably establish the diagnosis.

Treatment is rarely indicated in patients with platelet counts above 50 × 109/L in the absence of the following: bleeding due to platelet dysfunction or another hemostatic defect, trauma, surgery,31 clearly identified comorbidities for bleeding, mandated anticoagulation therapy, or in persons whose profession or lifestyle predisposes them to trauma. Patient preference must also be considered when discussing treatment options.
Although this states that treatment is not indicated with counts above 50k, most experienced hematologists do not recommend treatment until the patient reaches 20k or 30k, some even lower than that depending on symptoms.

www.bloodjournal.org/content/115/2/168.full?sso-checked=true

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Not sure what to think. Is the hematologist wrong? 1 year 7 months ago #60230

  • Natasha
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Since you're having digestive issues, I would get tested for H Plyori+ just to be sure.

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