Thrombocytopenia
Hello, Doctor.
I previously inquired about my mother, who was hospitalized due to low white blood cell counts caused by immunosuppressive therapy.
The doctor mentioned that her white blood cell count has stabilized, and her recent blood test showed a count of 2000, so she has been discharged.
However, her platelet count remains low, consistently around 30,000 to 40,000, and she is continuing treatment with steroids like "Lerazone." The doctor mentioned a new medication; could you please advise on how to apply for this new drug? The treating physicians have not mentioned this new medication and have only prescribed steroids, which make my mother feel very uncomfortable and weak.
I would greatly appreciate any information and suggestions you could provide.
Thank you, Doctor.
A-Kai, 20~29 year old female. Ask Date: 2012/04/03
Dr. Lin Sixie reply Rare Disease
Typically controlled with steroids, if the effect is unsatisfactory, consider Nplate (romiplostim) subcutaneous injection.
Please discuss with your physician.
Wishing you a speedy recovery.
Reply Date: 2012/04/03
More Info
Low platelet count, or thrombocytopenia, can be a challenging condition to manage, particularly when it is associated with other health issues, such as low white blood cell counts. In your mother's case, it appears that she is currently being treated with corticosteroids, which are commonly used to help increase platelet counts in conditions like Immune Thrombocytopenic Purpura (ITP). However, as you mentioned, corticosteroids can have significant side effects, including fatigue and discomfort, which can impact the quality of life.
When considering treatment options for low platelet counts, it is essential to understand the underlying cause of the thrombocytopenia. In cases where corticosteroids are ineffective or cause intolerable side effects, healthcare providers may consider alternative treatments, including newer medications. One such medication is Romiplostim (brand name Nplate), which is a thrombopoietin receptor agonist. It works by stimulating the bone marrow to produce more platelets. This medication is administered via subcutaneous injection and has been shown to be effective in increasing platelet counts in patients with chronic ITP.
To apply for new medications like Romiplostim, the first step is to have a thorough discussion with your mother's healthcare provider. They can evaluate her specific situation, including her medical history, current medications, and overall health status. If they believe that a new medication may be appropriate, they can provide a prescription and guide you through the process of obtaining it. In some cases, insurance coverage may be a consideration, so it is advisable to check with the insurance provider regarding coverage for new treatments.
In addition to Romiplostim, there are other treatment options available for managing low platelet counts, including:
1. Eltrombopag (Promacta): Another thrombopoietin receptor agonist that can be taken orally. It also stimulates platelet production and may be an option if Romiplostim is not suitable.
2. Danazol: This is an androgen that has been used in some cases of ITP, particularly in patients who do not respond to other treatments. It can help increase platelet counts by modulating the immune response.
3. Intravenous Immunoglobulin (IVIG): This treatment can temporarily increase platelet counts by providing antibodies that may help reduce the destruction of platelets.
4. Splenectomy: In some cases, surgical removal of the spleen may be considered, especially if the spleen is contributing to the destruction of platelets.
5. Platelet Transfusions: In acute situations where immediate increases in platelet counts are necessary, platelet transfusions may be performed, although this is typically a temporary solution.
It is also important to monitor your mother's overall health and any symptoms associated with low platelet counts, such as easy bruising, prolonged bleeding, or petechiae (small red or purple spots on the skin). Regular follow-ups with a hematologist or a specialist in blood disorders can provide ongoing support and adjustments to her treatment plan as needed.
In summary, while corticosteroids are a common first-line treatment for low platelet counts, there are newer medications and alternative therapies available that may be more suitable for your mother, especially if she is experiencing significant side effects. Engaging in an open dialogue with her healthcare provider will be crucial in determining the best course of action for her specific situation.
Similar Q&A
Effective Treatments and Diet to Boost Low Platelet Counts
What treatments or dietary changes can help increase platelet counts? The patient has been hospitalized for over a month, with platelet counts currently at 6,000 and now at 14,000, but there hasn't been much improvement.
Dr. Cai Jueren reply Family Medicine
Dear Sir/Madam, The normal platelet count for both males and females ranges from 150,000 to 400,000/μL. You mentioned in your inquiry that your platelet count is 14,000, and currently only 6,000. Is this correct? A platelet count below 20,000/μL may lead to spontaneous bleeding,...[Read More] Effective Treatments and Diet to Boost Low Platelet Counts
Understanding Low Platelet Counts: Seeking Medical Advice and Options
My father was found to have a platelet count of 6,000 on December 31, 2004. After hospitalization, his platelet count has remained between 14,000 and 20,000 (after platelet transfusions). The medications prescribed by Mackay Memorial Hospital include folic acid, B vitamins, antib...
Dr. Wang Fangli reply Internal Medicine
There are many causes of thrombocytopenia, and it is essential to consider other comorbid conditions and treat the underlying cause. You may discuss this with your attending physician. Wang Fangli, March 24, 2005.[Read More] Understanding Low Platelet Counts: Seeking Medical Advice and Options
Understanding the Impact of Atezolizumab on High Platelet Count and Thrombosis
Due to thrombocytosis causing thrombosis and myocardial infarction, I am currently taking Clopidogrel and Aspirin for management. However, my platelet count remains between 850,000 and 930,000. The hematologist has indicated that I have myeloproliferative neoplasm, and since I am...
Dr. Hu Ziren reply Oncology
Hello, netizen: 1. In primary thrombocythemia, if the platelet count exceeds 1 million or there is a history of stroke (thrombosis, etc.), it is recommended to use medication to control the platelet count to below 400,000; 2. Hydroxyurea (Hydrea) works by inhibiting DNA synthesis...[Read More] Understanding the Impact of Atezolizumab on High Platelet Count and Thrombosis
Alternative Treatments for Thrombocytopenia: Beyond Steroids and Splenectomy
Hello, I have several male friends who were diagnosed with thrombocytopenic purpura in middle school. They have been on long-term corticosteroids and immunosuppressants. The doctor once suggested a splenectomy, but the family opposed it unless absolutely necessary. Their platelet...
Dr. Chen Sirong reply Oncology
Hello, based on the information provided by the netizen, the patient is likely experiencing thrombocytopenic purpura due to a deficiency of platelets. In addition to corticosteroids and immunosuppressants, there are other treatment options available, including the aforementioned ...[Read More] Alternative Treatments for Thrombocytopenia: Beyond Steroids and Splenectomy
Related FAQ
Rare Disease Treatment
(Rare Disease)
Other(Rare Disease)
Congenital Metabolic Disorders(Rare Disease)
G6Pd Deficiency(Rare Disease)
Kawasaki Disease(Rare Disease)
Chromosomes(Rare Disease)
Height(Rare Disease)
Ichthyosis(Rare Disease)
Brittle Bone Disease(Rare Disease)
Newborn Screening(Rare Disease)