6 year old with ITP, falling counts, no symptoms

Hi,
Following a two week long viral gastro infection, our 6 year old daughter was diagnosed with ITP when blood samples (taken to investigate possible cases of the diarrhoea and vomiting) showed her platelet count to be 28. She has had two follow up CBCs, showing platet levels of 22, and today's test which was 18.

We have been advised to keep her off school for now, presumably until her platelet counts show signs of recovery. Other than low counts, she has no symptoms -no bruising of bleeding. And now that she has recovered from the gastro bug, she is getting quite bored of being at home and is keen to return to school.

Question: are these falling counts a cause for real concern? Reading the accounts of others on this site, many children seem to be able to tolerate low counts such as these pretty well, and no symptoms might indicate we are worrying needlessly.

We seem to be on a 'watch and wait' strategy, with regular blood tests. Her next one is for Tuesday next week (today being a Friday) and we have been asked to keep her off school until we get the result from that. Not sure what they are planning if it keeps falling. ITP appears to be rare enough for our GP to be quite at sea as a what to advise. And despite the lack of symptoms, we are anxious merely through watching the falling platelet levels.

All advice welcome!

Thanks
Rochelle

Hi Rochelle,

I am glad you found us. It is common for doctors to not be on top of all the latest on ITP, so it is up to you to learn all that you can. Also, you should be looking for a good pediatric hematologist in case your child's ITP does not resolve quickly.

There is nothing to be read from the pattern of your daughter's counts. Like the stock market, counts go up and down, and in hindsight there may be a pattern, but you can't tell much looking ahead. Let's hope this is acute, and will resolve itself before too long.

Thanks Rob. Yes, I think I would really benefit from speak directly to a paediatric haematologist, so far we have just seen our regular GP and they have been liaising with the specialist. If we're going to be doing watch and wait with regular CBCs, then I need to know what they are watching and waiting for!

She doesn't appear to have petechia, but I have noticed the slightest bump is now resulting in a dark bruise. It certainly keeps you on edge as a parent.

Just a comment - the watching part of Watch and Wait is supposed to be for symptoms not counts. Don't get sucked into watching counts because its a fast route to insanity I found that getting a count done was best done infrequently, maybe every six months or so.

Good luck