Day 227 - Where Have all the Platelets Gone?

Cindy's condition keeps on improving.  She is becoming more awake and beginning to be more responsive.  The doctors are continuing to wean her off some of the medications and administer just medications for the pulmonary hypertension.  The cardiologist is happy with her progress.  She is even beginning to lose some of the fluids that have become a major problem (7 pounds).

The pulmunologist told us that her blood platelet count was low and they had no idea why.  Her count yesterday was 19,000 and today it is 17,000.  Platelet count should be between 150,000 and 450,000.  Platelets are made by the bone marrow and plays an important role in blood clotting and preventing blood loss.  Yesterday, when Cindy's Pulmonary Artery Catheter was removed, there was a lot of blood loss.  It took ten minutes to stop the bleeding.

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Low platelet count, also know n as Thrombocytopenia, can be caused by many reasons:

• Bone Marrow can't make enough platelets
• Cancer, such as leukemia and lymphoma, can damage the bone marrow
• Aplastic Anemia, a rare blood disorder that interferes with platelet production in the bone marrow 
• Exposure to toxic chemicals can slow the production of platelets
• Certain medicines can slow the production of platelets.  One of them is diuretics.
• Alcohol can also slow the production of platelets
• Viruses, such as chickenpox, mumps, etc., can decrease platelet count temporarily.
• Genetic conditions can lower platelet count
• Infections can lower platelet count

All of the above reasons were ruled out.  One more possible reason for a low platelet count is an autoimmune disease called ITP.  ITP mistakenly attacks platelets assuming they are antibodies that fight infection and disease. 

A Hematologist came in to exam Cindy.  He thinks that the low platelet reading might not be correct.  He is going to do more testing to see if the materials used in the platelet lab work compromised the results.  If there is no problem with the platelet count, it is probably ITP and Cindy will probably get a platelet transfusion and/or steroids.