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475555 tn?1469304339

No change in platelet count on S+O Tx?

Hi, all.

I started therapy with Sovaldi and Olysio three weeks ago. I just got the results from my first blood analisis: the platelet count is still down around 100k, which is where it was before starting Tx, even though my transaminases (ALT and AST) have gone way down to the normal range.

Can anyone tell me if this is normal, that is, if platelets take a long time to go back up?

Thanks.

Mike
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683231 tn?1467323017
Thanks for clearing that up for me Charlie
I was just kinda confused by that.

Congrats on your transplant

may you live long and prosper

Sorry Star Trek nerd here lol
Lynn
Helpful - 0
Avatar universal
Hi Lynn, yes I did say "high" should have been many years of being low. Right after transplant they shot up to normal range almost immediately. I'm only 33 days out of transplant and my enzyme levels are all normal also. They started getting back to normal the first week on S/O tx. Thanks Lynn, good eye. Best to you.
Regards,
Charlie
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Avatar universal
" Common causes of thrombocytopenia due to splenic enlargement may include advanced liver disease with portal hypertension (cirrhosis, for example, from chronic hepatitis B or C)"

Bingo...We have a winner. My spleen is trapping platelets and destroying them. I don't intend to have it removed unless something catastrophic happens like an injury.
Bucky
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475555 tn?1469304339
The platelet count result should be expressed as the number of platelets per cubic milimeter of blood (No./mm3). The low limit of normal is usually given as 150,000.

Hope this helps.
Helpful - 0
683231 tn?1467323017
Found some more info about low platelets, cirrhosis and enlarged spleen

http://www.medicinenet.com/script/main/mobileart.asp?articlekey=100173&page=3

Splenic sequestration

Splenic sequestration can also lead to low platelet counts as a result of enlargement or change in function of the spleen for a variety of reasons. When the spleen enlarges, it can retain (sequester) more than the usual amount of platelets. Common causes of thrombocytopenia due to splenic enlargement may include advanced liver disease with portal hypertension (cirrhosis, for example, from chronic hepatitis B or C) and blood cancers (leukemias or lymphomas).
Helpful - 0
Avatar universal
Removal of your spleen just because of platelets at 60 sounds like a really bad idea to me. My platelets were down to 65 but have gone up to 85 and then 80 while on tx and even when they were at 65 I was totally fine in that if I'd cut myself my blood would clot quickly, just as it did before they got low. A couple of doctors have told me that they don't worry about low platelets until they get down below 35. So, keep that spleen.

Keeping On, that's interesting about the blood thinning to help the damaged liver. Makes sense.
Helpful - 0
Avatar universal
It's all up to the liver not the spleen. A liver doc told me long ago that the low platelets helps to thin the blood so it can pass through the damaged  liver. On the downside you may have bleedouts. Getting rid of this bug saves the liver from further damage. As my current doc's team said, it should all come back over time after SVR. Easy there on the thoughts about removing your spleen.

My platelets are 50,000 and I do ok with it for now.
Helpful - 0
683231 tn?1467323017
Oops

And you posted your platelets as 55,000 which is low. Was that test before your transplant?

So anyway that is why I am confused.

But anyway congratulations on your transplant I hope you have many many health happy days in your future.  :-)

Lynn
Helpful - 0
683231 tn?1467323017
Hi Charlie

Ok I am just a little confused. You said your platelets were high before transplant and are now normal?

I have F4 cirrhosis and my platelets are low at 90 ish. The lab my doctor uses say normal is 150-379 and that low platelets are common in cirrhosis due to portal hypertension and the resulting spleen enlargement resulting in sequestering of platelets in the spleen. So commonly people with cirrhosis at least what I have read have low platelet counts.

You
Helpful - 0
Avatar universal
Wow, how lucky are you!!! I am new on this forum and did not know that you just had a transplant. My IDS and Hepatologist both said that we would wait a year and see how my numbers look. I have my SVR12 in two weeks so that is the next hurdle. If I remain UD and my liver heals some then there is a chance that my portal hypertension will improve and help out my old spleen. Besides a transplant which I don't need as of yet, the next thing that could be considered to raise my platelet count is to remove my spleen. We are all against that as the spleen is involved with the immune system. A good liver is needed if you loose your spleen and I don't have a great one of those.
Bucky
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Avatar universal
Hi Bucky, yes it was enlarged when I had cirrhosis, I am newly transplanted (10-28-14) and my platelets are back to normal after many years of being high...but that's a good question, never thought about that I'll have to ask my doc if it's still enlarged. Now I'm wondering if mine was removed, I know my gallbladder was. Thanks

Regards,
Charlie
Helpful - 0
Avatar universal
Hi Charlie,
Is your spleen enlarged as well?
I used to freak out about my low platelets but a surgeon friend of mine said that since my INR was still normal that I could have surgery for something if needed. I live in the gallbladder belt and most of my friends have had theirs removed.
Bucky  
Helpful - 0
Avatar universal
Hi hepcandme, yes on my labs from quest they read as follows:

Test Name       Out Of Range        Reference Range Lab
PLATELET        COUNT 55 L         140-400 Thousand/uL

which means 55,000.

Regards,
Charlie
Helpful - 0
6708370 tn?1471490210
I am confused how to read the platelet lab results

http://www.mayoclinic.org/tests-procedures/complete-blood-count/basics/results/prc-20014088

When someone says their platelet count is 70,000, it's the same as another person saying 70?

It doesn't help that in my labs, the test results don't give a number at all. Only, normal, decrease or increase
Helpful - 0
475555 tn?1469304339
Hi, Lynn.

I am so glad to hear that you got right onto Harvoni. I am sure you will SVR this time. My thoughts and wishes are with you, as they are with everyone here.

Mike
Helpful - 0
475555 tn?1469304339
Hi, Dee. So nice to hear from you. I'm doing okay so far, no sides except for the usual headaches.

How's life post-SVR?

A big hug for you.

Mike
Helpful - 0
475555 tn?1469304339
Thank you all very much for your helpful comments. I feel relieved to know that others have experienced similar things with their platelet count. It really is tremendously reassuring to learn that one is not alone with these issues.

For those who SVRed, congratulations! For those who like me are still on treatment, I am sleeping with my fingers crossed for us.

Cheers.

Mike
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Avatar universal
Mike,
My platelets are real low 60,000 but my INR time is normal. My spleen is enlarged and is ripping up my platelets. Thankfully I have no bleeding problems. IDS said that my platelets may never be within the normal range but since my INR was normal to not really be concerned. I was given the OK to ski this winter and I have!
Bucky
Helpful - 0
Avatar universal
Hi Mike,

My platelets were declining for years. A biopsy in June 2013 showed F2-3 fibrosis. At this time my platelets were at 188. I finished 12 weeks of Sofosbuvir/Ribavirin in April 2014 and my platelets were 171. During treatment they shot up to 235 but as Kim mentions above they returned to previous levels, even a bit lower after treatment ended. 12 weeks post EOT in July 2015 my platelets were 155, just barely above the lower limit of normal of 150. I did achieve my SVR12 thankfully. in October 2014 at 24 weeks EOT they shot up to 192.  

So it took 6 months after I finished treatment for my numbers to start to rebound. If you have cirrhosis it might take longer. But I wouldn't expect any real change short term.

Hope this helps.
Helpful - 0
Avatar universal
Hi Mike.  I treated with Sovl/Riba for 12 weeks.  My beginning platelet count was 125.  During Tx my platelets stayed in the 200s.  After Tx my platelets went back to 118.  Kinda confused as to why that happened but platelets while on Tx can stay constant or fluctuate.  It is not indicative of response or whether you will SVR.  It seems that once Tx ends, they will return to where you began.  S/O seems to lower the counts for most.
It is also my understanding that it can take a year or more post SVR to begin reversal if any.  You don't finish Tx, and they then start improving.  It took a long time for them to go in a downward trend, and awhile for improvement should it occur.
Best wishes with Tx
.....Kim
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7395021 tn?1394075927
Congratulations  on getting started and having your first blood check. I finished triple treatment about the same time as Hepc4Sandi. My platelet count dropped during treatment and very slowly came up after treatment. My AST is still slightly elevated and ALT normal. I have compensated cirrhosis and feel pretty good. You are doing well Mike.
Helpful - 0
9683500 tn?1407864284
I treated with S/O, reached SVR Oct. 23rd. I have cirrhosis.  My platelets have been in the low 60's since I was diagnosed last January. There was a slight increase in platelets at my 12 week EOT test in October, but nothing really significant.  My hepatologist says that over time my liver funcion and platelet situation might improve, so for now I'm just concentrating on eating a healthy diet to help my liver function improve as much as possible. Time will tell. Good luck with treatment!
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Avatar universal
Got a call from docs office. Says platelets still low but should improve over time- post tx S/O. Went from UD to NV to waiting for SVR.
Gums feeling better post tx as well as breathing better.
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315737 tn?1407298997
I treated twice with Ribavirin and Interferon and my platelets ere below normal during treatment but had been a bit above the low end out of treatment. After the last treatment my platelets stayed in low normal range but took a bit of dip just before we decided to treat again.  They have stayed normal all during Sovaldi and Ribavirin. I'd imagine it might take some time for your liver to recover and platelets go up ie your liver does some self repair if otherwise healthy.
Helpful - 0
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