Does a grade 1 thrombocytopenia require treatment?

Question

Hello doctor,

My three-year-old son has been suffering from a low platelet count (1,20,000 platelets per microliter of blood) for about six months. Approximately one year ago, he was diagnosed with a low hemoglobin count due to iron deficiency and was treated with iron supplement syrup for eight months. The doctor has prescribed Eltrombopag, Olamine 12.5 mg per day. This prescription was given approximately two months ago and the medication has been continued for two months. He was previously taking Prednisolone 20 mg and Folic acid 5 mg per day for two months, but it was not very effective. Currently, the fluctuation in his platelet count is causing anxiety for us. However, other CBC (complete blood count) parameters, including hemoglobin, are within the normal range. I would appreciate any suggestions for his treatment.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

For a platelet level of 1,20,000 platelets per microliter of blood, no treatment is needed. Unfortunately, I could not open your reports file. The management of low platelets or thrombocytopenia includes:

Grade 1 thrombocytopenia: Platelet count ranging between 75,000 to 150,000. No action is needed, just follow up.
Grade 2 thrombocytopenia: Platelet count ranging between 50,000 to 74,000. Do not panic, but investigate the cause. Common causes are nutritional deficiency, chronic infections, chronic liver disease (CLD), or drug-induced destruction.
Grade 3 thrombocytopenia: Platelet count ranging between 25,000 to 49,000. Do not panic about the platelet count, but focus on identifying the cause. Possible causes may include septicemia, immune thrombocytopenic purpura (ITP), bone marrow infiltration, or chronic liver disease (CLD).
Grade 4 thrombocytopenia: Platelet count ranging between 5,000 to 24,000. This requires concern for both platelet count and the underlying cause. However, platelet transfusion is not necessary. Frequent monitoring of the patient is needed. The causes may include acute ITP, septicemia, disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), acute leukemia, and aplastic anemia.
Grade 5 thrombocytopenia: Platelet count falls below 5,000. This is considered critically low platelets and requires hospitalization and immediate platelet transfusion.

Your above-mentioned symptoms align with those of grade 1 thrombocytopenia.

Thank you.

I hope your query got resolved.

Please feel free to reach me again, in case of further queries.