My husband was recently given the news he has hep C. We have done all the test including liver bio. And were ready to start treatment but was not allowed to due to very low platelets is there any way to get the count up? Is this common? Also we are going back to the doctors. What questions should I ask - I think we were in too much shock to ask the correct ones till this point? I'm just starting to learn how to handle this and would like any help.
The platelet count goes between 40 and 100. It has dropped down to 40 twice in the last month and a half. We have been monitoring them weekly to make sure they do not go below this level. There is some liver damage but the doctor said not much but has said nothing about any spleen damage how do they test for this ?
How low is Low what numbers did they give you? Need more info. I know how you feel. I have low platelets also. How did his liver biopsy come back?
I have low platelets due to cirrhosis and enlarged spleen. I started treatment when my platelets were 74. Duing treatment they did go to 50. The doctor said if they drop really low. I might need a platelet transfusion. Mine went up the next time they tested. I guess the liver and spleen started to respond to the treatment. Some people have treated with very low platelets. You need to make sure the doctor is willing to due what it takes to help him. I hope someone comes along to answer your queston, that may have been lower platelet than mine. But please give more info as to the biopsy report and the numbers on the platelet. sorry you are having to go through this. Take Care
Did your husbands dr. do a biopsy and Genotype, Viral load test? These will let you know the stages of liver damage and how to tx the hep c.
My platelets were 120 when I started and went down to 70 and now are back up to 130. Not sure why as I didn't have a biopsy. I know that the tx does lower platelets in many people, but they usually tx them if they are at a high stage of diease.
I would definately get all your numbers and lab papers together and let us know what the Genotype and stage is. We are NOT doctors here but many have a lot of experience with this. Perhaps you can get a second opinion from a Hepatologist.
How they tell if your spleen is enlarged is through an ultra sound. The spleen is responsable for platelets, along with the liver. I can't believe his platelets are so low, with such a small amount of liver damage. Sometimes it is genetic. Or has he been on any antibiotics for a long period of time? I know that can lower them, but they should bounce back. I have heard of blood platelet transfusion or vitamin K shots. I know of someone who had their spleen removed and the platelets went up. Sorry not much help here. Just things I have heard about.
Sorry your having such a stressful time. Maybe you'll find some helpful info here: <a href="http://www.clevelandclinicmeded.com/ccjm/april04/george.htm">Thrombocytopenic patients can be divided into two groups: those who are healthy except for their low platelet count and those who have systemic illnesses.</a>
Low platelets can be a very big problem starting tx and being able to stay on tx. You will find here that it seems that everyones Dr. has a different threshold for low platelets. I started tx at 67, (due to enlarged spleen) on tx in the low 30's (week 41). Two weeks ago my labs (CBC) came back with platelets at 25, I was sent in the next day for a retest and they were at 23. Not looking good! Dr. will cut my Peg if this trend continues on next CBC. The NP has told me they had a patient drop to 14 and cut his Peg. What my Dr worries about is internal bleeding.
Problem is they can boost your WBC and your RBC with rescue drugs but their is nothing they can do for your Platelets except a Platelet transusion and per my Dr that is only for emergency.
My opinion is that you need to know why the Platelets are low and need to discuss with your Dr., hopefully a Hepatologist. Get a second opinion. Good luck.
Thanks for all the information. I think in reading he has already had every test that is posted. I added up all the medical bills and noted what test they were for, I figure for almost 23,000 we should have some results. In my big folder of bills there is really nothing from the Dr except a Cd of one of the tests. So I am a getting ready for the next visit.(I'm not sure if I like him at this point but I am not the one he is treating, but I think we should have some information). The list of questions to ask (Please add any if I missed something) are as follows;
As for diet we are eating healthy here... And of course no drinking alcohol, or using any products containing it. :). Thinking of getting some vitamin K for him figure it can't hurt. And keep on reading the forum to learn more. Its nice to know that were not alone.
All the values you have listed should be on his CBC results. They miht or might not use the abbreviations but after 23,000 in tests he has to have a CBC Usually the first thing they do is a CBC. They might have a "hepatic panel" test result page listed on another page, mine is listed in one continuous list but they differ. That seems like an incredibly huge amount for testing! I hope you have copies of the results, maybe you can gather all the test results together and see if you can make head or tails of it. I think the CD might be his biopsy slides.
The spleen becomes enlarged and sequesters platelets. It appears that with liver damage from hep c the bone marrow produces fewer platelets. So together - fewer produced platelets and platelet sequestration - is why cirrhotics often have low platelet counts.
Review article: blood platelet number and function in chronic liver disease and cirrhosis
Background The liver plays a central role in coagulation and fibrinolysis but is also closely intertwined with the function and number of blood platelets.
Aim To describe and integrate all literature concerning blood platelets and liver disease by performing a thorough literature research.
Methods A thorough literature research on ‘blood platelets’ and ‘liver disease’ was performed.
Results Thrombocytopenia is a marked feature of chronic liver disease and cirrhosis. Traditionally, this thrombocytopenia was attributed to passive platelet sequestration in the spleen. More recent insights suggest an increased platelet breakdown and to a lesser extent decreased platelet production plays a more important role. Besides the reduction in number, other studies suggest functional platelet defects. This platelet dysfunction is probably both intrinsic to the platelets and secondary to soluble plasma factors. It reflects not only a decrease in aggregability, but also an activation of the intrinsic inhibitory pathways. The net effect, finally, is a decreased platelet function in the various types of chronic liver diseases and cirrhosis. Finally, recent data suggest that platelets are not only affected by but can also contribute to the liver disease process, as for instance, in viral hepatitis and cholestatic liver disease.
Conclusion Platelet research in liver disease is a growing area of investigation and could provide new pathophysiological insights.
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