I'm looking for some guidelines on when low platelets can be ignored vs need to seek medical attention to measure counts. The situation is a bit unusual in that my 17 yr old daughter has what I call "recurrent acute ITP". Her counts are normal until she gets a virus or even a flu shot. Then they crash. Once the trigger has resolved, her counts rebound to normal. She's been admitted to the hospital three times and treated with IViG twice in the last 6 years. Our experience is that recovering from IViG is physically worse than waiting for the rebound.
When she gets petechia on her legs, her count is usually below 30K. When she's sick it often crashes to 8-20K before rebounding. Last fall she had a cold and the platelets fell to 18K. We always ran to the doctors for blood work whenever we saw petechia. Thankfully the doctors said wait till the next morning and measure, and she was rebounding to 33K the next day and normal within 5 days.
Our first watchful waiting with skipping the doctors was after her h1n1 flu shot. She had petechia, but she was so worn down from treatment for Lyme disease and we knew it was the flu shot causing it which should be a quick recovery, and no bleeding, so we skipped the doctors and all seemed well in a day or two.
Last week she had a cold. Sure enough on day 3 of cold, the petechia came out. But we were snowed in with fallen trees across the driveway and regional state of emergency due to 25 inches of snow. We opted to watch it. She also had one blood blister in her mouth. Her platelets rebounded because the petechiae disappeared within two days. (she also was exhausted on day 5 of the cold, like her body was going into overdrive making platelets, she couldn't function too well even though the cold was resolving).
She's never had nose bleeds. I read in another thread that a blood blister in mouth was a warning sign that it is more severe.
Are there symptoms that indicate we should not try to wait it out and she needs to closely follow counts? i.e. blood blisters in mouth? If it is a longer illness or more severe like the flu, I think the rebound might be too late to wait it out..
She's off to college next year so I'm getting paranoid about learning when she needs to monitor counts closely or when she can bubble wrap herself and wait it out.
Any advice?
Thanks
