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low platelets
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low platelets

My plt count was 44 today. Three wks ago it was 88. The Dr.says we will check it again next week and may have to lower the interferon from 380mcg to something. We already lowered the rib from 1200 to 600.
     My question is, does anyone have any info on this problem?
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446474_tn?1385271190
Do you have cirrhosis?  People with cirrhosis start out with a lower platelet count than others with less liver damage. Usually less than 125,000 and many times less then 100,000 platelets. Only people with cirrhosis or other platelet issues need to worry about platelets dropping dangerously low. 20,000 or less. Interferon causes all treating persons platelets to drop to some degree. Obviously the more platelets you start with before treatment, the higher the platelet count will stay.

For people with cirrhosis who want or need to continue treatment they can have a transfusion of platelets every so often or Promacta, a drug that raises platelet counts. Both of those can only be managed by a hepatologist working at a liver transplant center.  A gastroenterologist is not qualified to manage a patient with cirrhosis.

By the way, 44,000 is plenty of platelets. Nothing to worry about. Many cirrhotics live for years with platelet counts in the 40,000 - 50,000 range.

As I said above, Interferon NOT Ribavirin causes the platelet count to drop. By reducing the dosage of Interferon your platelet count will rise.

It is important to realize each doctor is different in what they consider a dangerous platelet count. Some are not comfortable under 30,000, other are fine until getting close to 20,000.

According to the label on Interferon the dosage should be reduced or stopped according to the following guideline.

2.4 Dose Modifications

Platelet <50,000 cells/mm3 - Reduce to 90 mcg
Platelet <25,000 cells/mm3 - Discontinue treatment

Good luck with your treatment.

Hector
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12 Comments Post a Comment
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Avatar_f_tn
  Hmmm, well, definitely dont have any medical procedures done right now, because your body may have trouble clotting blood, but that is generally when you go under 20.
   I just got my Inf shot, so I am kind of too tired to remember what Ihave read on this, but I remember there being one rescue med for this, someone else will come along and tell you. Also, I think a blood transfusion...but I am having brain fog right now- My platelet count is 90 right now, after 8 weeks treatment, I started out at 120.  It has been bouncing around, and yours may go back up, hopefully
  
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163305_tn?1333672171
I'm going to guess you meant to say lowering your interferon from 180.
(If you did mean 380, why are you taking so much ?)

Drops in platelets are not unusual during tx. The first time I did tx, mine dropped down into the 20s.
At that time there was no med to increase platelets. I don't know that there is any now, either.

My hepatologist made it clear that the danger from low platelets is that if you were to be in accident, you could have internal bleeding problems due to the clotting issue. It's not that you will bleed excessively from a cut.
So, do be careful.
He did not lower my dosages at the time. Not sure why your doctor is.

Good luck.
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2025701_tn?1328923233
thnx for your input and yes it is 180mcg.
I feel better hearing this info., and will tell him not to lower it unless the plt's get much lower.
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163305_tn?1333672171
http://www.biomedcentral.com/content/pdf/1471-230X-12-7.pdf
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2025701_tn?1328923233
thnx for the link.
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Avatar_f_tn
I agree with hawk. I am on week 38 and my platelets were at 22 last check. They have been in the 20s range for weeks now and I have not had to lower my meds. Hang in there!
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Avatar_f_tn
That 380 threw me for a loop, being new to this and mine is only 180. Thanks for catching that, OH; I would have been all over the internet trying to figure out my tx, lol! Definitely a mistake/typo I could make, so I get that.

Week 1 and mine dropped from 82 (not a good start, but TG they let me start) to 56 and they are talking that most likely they will drop the 180 next week. Sounds like they must be kind of jumping the gun on me?
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Avatar_f_tn
Great link! Answers a lot of my questions. Thanks.
http://www.biomedcentral.com/content/pdf/1471-230X-12-7.pdf
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446474_tn?1385271190
Do you have cirrhosis?  People with cirrhosis start out with a lower platelet count than others with less liver damage. Usually less than 125,000 and many times less then 100,000 platelets. Only people with cirrhosis or other platelet issues need to worry about platelets dropping dangerously low. 20,000 or less. Interferon causes all treating persons platelets to drop to some degree. Obviously the more platelets you start with before treatment, the higher the platelet count will stay.

For people with cirrhosis who want or need to continue treatment they can have a transfusion of platelets every so often or Promacta, a drug that raises platelet counts. Both of those can only be managed by a hepatologist working at a liver transplant center.  A gastroenterologist is not qualified to manage a patient with cirrhosis.

By the way, 44,000 is plenty of platelets. Nothing to worry about. Many cirrhotics live for years with platelet counts in the 40,000 - 50,000 range.

As I said above, Interferon NOT Ribavirin causes the platelet count to drop. By reducing the dosage of Interferon your platelet count will rise.

It is important to realize each doctor is different in what they consider a dangerous platelet count. Some are not comfortable under 30,000, other are fine until getting close to 20,000.

According to the label on Interferon the dosage should be reduced or stopped according to the following guideline.

2.4 Dose Modifications

Platelet <50,000 cells/mm3 - Reduce to 90 mcg
Platelet <25,000 cells/mm3 - Discontinue treatment

Good luck with your treatment.

Hector
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2004810_tn?1365157211
Hi,
sorry for interrupting on this thread. Just wanted to know how I can find my platelet count? I'm from Norway and I can't find any terms on my bloodworks saying "platelets". Is there another name for it?
B-Leukocytes?
Lk-Neutrophils?

I can't find any numbers at 50 000...is there another way of mesuring this?

Again; sorry for interrupting...just in case you can answer, Hector? Thanks..
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1669790_tn?1333666195
On my lab reports it shows as either Plat or PLT and the units are K/uL.  So if the platelets are 90,000, it would show 90 K/uL.  
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Avatar_m_tn
Hi Bovary.. plats would probably show the same as here in Canada .
In the U.S it would be expressed as cyclist mentions ,
A typical lab report would  say 150,000 -350,000 /ml  being normal range.
Here in Canada and most probably where you are that would be expressed  as 150 --350  x10   9L

Hope that helps..
Will
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