Hematology/SHARP FALL IN PLATELET
QUESTION: dear doctor,
thank you for your previous replies.
My 13 yr old daughter had severe iron deficiency anemia Hb 6.8,ferritin 6.42
since 5th june 2013 she is on iron supplementation,by now
her Hb is 13.3 , ferritin 49 and other figures are almost within
the normal range. But what bothers me is a constant fall in her
platelet count as the Hb is rising.
I know this is within normal range, but what
is to be done for this sharp fall please advise.
Does this happen during correction of iron deficiency anemia?
ANSWER: Hello Sambudha!
Warm welcome to you!
No need to worry this phenomenon is typical in Iron deficiency Anemia. When there is anemia body sends hormonal signals to bone marrow to increase the production of RBCs. Since RBCs and platelets both are produced in the bone marrow only, this hormonal signal increases the production of both RBCs and platelets. So in anemia there in increased platelet count. But when the patient starts taking supplement and body gets enough iron, this hormonal signal diminishes thus bringing back the platelet count to normal level. As long as its in normal range you dont have to worry at all. Even severe dengue patients survive with a platelet count as low as 20 thousand. So relax no need to panic.
Have a great day!
***Dear AllExperts user, If you are satisfied with my service, please take your time to donate a little money for providing medical facilities and education to poor.You can donate as less as 5$ - 10$. Your little donation can save lives!! Please donate only if you are satisfied with the service and willing to help poor. I dont want to force you! Thanking you!
Account Details: SHRINIDHI LAXMAN KULKARNI A/C No. 04152010144683 IFSC CODE:SYNB0000415 BRANCH DETAILS:BANGALORE N R COLONY, No.1 FIRST MAIN ROAD, N R COLONY, BANGALORE 560019 ***
---------- FOLLOW-UP ----------
QUESTION: Dear Doctor,
Thanks for your prompt reply and help. After the last report in october
the doctor said it is all normal now ,so immediate followup is not necessary.
The tonoferon dose was also reduced to 3.5 ml from 5.0 ml. Now after seven months the bloodwork is repeated and i am surprised to see both the Hb and
ferritin has come down again Hb (from 13.3 to 12.6) and ferritin (from 41.7 to 21.3)
other figures remain within normal range. I donot understand when the initial response was so good ,(from may to october her Hb went up to 13.3 from 6.8 and ferritin went up to 41.7 from 6.42) why this is dropping again when the supplement is not stopped. Her platelet also has risen to 2,13,000 from 1,76,000 once again.
If she had any other problem ,the initial response would have failed ,but it was detected Iron def anemia both in our city and CMC vellore. Her
periods are @20 days and stays for 4 days moderate bleeding.
Warm welcome to you!
Hb of 12.6 is normal for a girl so dont worry. But Definitely serum ferritin need to be raised a little. May be upto 80-100ng/mL.
Also platelet count is also in normal range. Its elevated because of slight drop in ferritin.
Continue giving tonopheron. If possible give her (Vitamin C supplement) CELIN - 500mg/CELL-C 500mg/REDOXON 500mg Once daily for 1 month. Along with it give her foods rich in vitamin C(lemon, orange, tomato, potato, cabbage). Does she have any other symptoms? How is her serum calcium level? Please send her weight and height.