Low Platelet Count

P/C office called and my bloodwork showed platelet count was 120.  I go to my rheumy every 3 months and he did not mention it last time I saw him in March so I figured it was okay.  My p/c said to come back in 1 month for another bloodtest.  
My meds are: Prednisone 5 mg, Arava 10 mg, Folic Acid 1 mg, Actonel 35 mg, and Enbrel 25 mg 2 x a week injections (been on enbrel for 6 months or more).  

1)I know enbrel can cause low counts.  I do not have symptoms except except night sweats (I'm 58) but do get little spider veins on my face and a flushed face in the am.  I do notice after showering that the veins are quite distinct. Not sure if that has to do with the ITP (or what they call low platelet counts).  

2) Is 120 dangerous? I am going on vacation for 2 weeks and a little concerned.  I know I read that drs will sometime increase the prednisone to raise the platelet count.  I will talk to my rheumy on Monday.  

3) Why do drs offices call on Friday with results at 5:30 when the drs have left for the weekend?  (You don't have to answer that)..lol  

4) The nurse said the doctor thought it may be related to my medication..and if so....what would the next step be?  Since the enbrel helps my inflammation but may likely lower my platelets.  Decrease med..try another..increase prednisone?  I know your not my dr and haven't seen me but in general what would he/she do in this case?

Thanks you!  Paula  

[Kevin Pho, MD]

To answer your questions:
1) ITP can be a cause of low platelets.  Looking at the peripheral smear and possible antibody platelet testing can be considered if this is suspected.  

2) A platelet count of 120 is not low enough to cause spontaneous bleeding.  By itself, it is not a contraindication to travel, but this needs to be discussed with your personal physician.

4) It may be related to the medications you are taking.  Repeating the platelet count periodically should be done to ensure the levels aren't dropping.  A transient viral infection can also lead to low platelets, which is why repeating the test should be considered.  

A referral to a hematologist can be considered if the symptoms continue.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

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