Saturday 31 May 2014

Spontaneous bleeding and platelet drop

A condition of falling platelet counts and spontaneous bleeding and bruising.

M (Female, 3 years)
Medical History -When the child was three years many blue patches appearing on her skin. A blood test revealed a very low platelet count of 12,000. Two months later her eye started bleeding after getting hit lightly. The other eye also started bleeding on its own.

The family was in Singapore and the hospital there advised them to leave for India immediately for treatment. Both the eyes were bleeding and the eyes were sticky with mucus. From the airport they went straight to the hospital, and the child was placed in ICU for 4 days. Her platelet count was less that 5000 at that time. She underwent IVIG treatment, and 5 vials of medicines, each costing Rs. 15,000/- were given intravenously. After this she started having vomits and headache. The mother said these were known side effects of the treatment. She also developed fever subsequently. The child was also put through bone marrow aspiration. Her condition was diagnosed as idiopathic thrombocytopenic purpura.

After the IVIG treatment her platelet count increased to 1.58 lakhs/ cu mm, and then to 2.52 lakhs/ cu mm. but in 15 days it again reduced to 38,000. Four days later it reduced further to 12,000. The mother was told that some patients responded to a single IVIG treatment, and some others needed multiple treatments. The child was advised another round of treatment and steroids. But it was also said that there was no assurance of improvement.

The mother said that just before this condition surfaced the child had been given two vaccines- Hepatitis A vaccine and flu vaccine(H1N1). She said that subsequently she had heard that the vaccines can cause a platelet drop.

Treatment

When the patient came in December 2012 she had used to develop five or six, slightly raise blue black patches every month. These patches would be slightly painful in the beginning, but not subsequently. There had also been unprovoked bleeding from the eyes. These conditions had surfaced only two months ago. The platelet count was reported to be 12,000.The child was given Aadathoda kashayam and Mahatikta Grutham.

The parents came on 6th February because the corner of her right eye was reddish, and previously such reddishness had led to bleeding from the eye.  Vasa grutham and Rajanyadi churnam were prescribed. The reddishness disappeared, and the child stayed well. The blue patches on the skin did not appear. In between a condition of cough was addressed with Aadathoda kashayam.

A blood test was taken on March 11 2013 and it showed a platelet count of over 1 lakh. She has been well since.

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