What causes platelet count to decrease post-transfusions?

Question

Hello doctor,

My brother has dengue fever. His platelet counts were dropping and once they reached 18,000 he was given one unit of platelet transfusion. But, his counts did not increase when checked after four hours and was at 17,000. So, the doctor went for a second infusion. There are no other symptoms except for this. Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

Firstly, do not panic. Dengue is a self-recovering condition. His platelet counts will gradually rise.

Platelet transfusion is fine. Normally, random donor platelets (RDP) increases the platelet count by 5000 only while single donor platelets (SDP) increases it by around 30,000 to 40,000. So, you need to request your local doctor if he can make arrangements for single donor platelets.

The next thing is, to increase the platelets, he can take tablet Caripill 1100 mg three times a day for five days which is papaya leaf extract, and it is hypothesized to increase platelets counts. So, you can request a local physician for the same, as there is no harm in having it.

Most importantly, the priority is to avoid bleeding till his platelet count rises. So, he should strictly avoid painkillers except for Paracetamol, outdoor activities, brushing, straining at urination and defecation and any activities which may prone him to injury bleeding.

He should drink plenty of water and liquids nearly three to four liters a day.
His platelet count and hematocrit need to be monitored at least two times a day.

Hope this helps you. Get back if you have any doubts.

For more information consult an internal medicine physician online.

Answer 2

Hello,

Welcome back to icliniq.com.

You are welcome. All the best.

For further queries consult an internal medicine physician online.

Answer 3

Hello,

Welcome back to icliniq.com.

Do not worry.

Ask your doctor for manual platelet count as a machine can wrongly interpret the platelet clumps as a single platelet and falsely give a lower count. Probably, this is the reason for his low platelets count.

If the platelets which are transfused are old, say three to four days old, then the platelets degenerate. So, it should be fresh.

In fact, a count of more than 10,000 is alright. We do not strictly need transfusion above this, but we need to strictly take precautions which I mentioned earlier.

To be on the safer side, please arrange a person with the same blood group and get SDP from that person. Otherwise, he is probably in a trough and his platelets will rise in 24 to 48 hours.

All the best.

For more information consult an internal medicine physician online.