The other night I saw a patient with the lowest confirmed platelet I have ever seen. 1200 (or 1.2). She came in for rash (which was petechial) and while we were waiting for the labs to come back, she started spontaneously bleeding from her mouth, rectum, urethra, and vagina. Holy ITP Batman!
Update. I just saw the next day that the platelet count had dropped to 0.448! (or 488)!!!!!
Yikes!
We had a kid the other day with a platelet count of 2.0 – no spontaneous bleeding, though.
WOW! That’s amazing.
We beat our platelet low the other night too. My patient who previously had the lowest plt count I’ve ever seen (4) beat her own record and came back at 1 the other night. Again, no bleeding. Our patients do amazingly well with low platelet counts. We generally don’t transfuse til they’re under 10. This same pt keeps having low hgbs. The day her plt was 1 her hgb was 5. Her bone marrow is just shot to hell from too much chemo and radiation after years of relapses and remissions.
What’s the differential for such low platelet count?
So what was her deal? Why did she start bleeding from every orifice???
Chris, I would think ITP and thrombocytopenia caused by hematological malignancies and chemo/radiation would be the most common causes.
Layman here:
Is it wrong to scream “Oh my god!” when a patient starts to bleed from every orifice?
Or is that what “Code Blue” (or Red) means?
You try not to say OMG to patients. It upsets them. Code blue means someone had a cardiac arrest.
Yeah, now that you mention it, I would be kind of freaked out if my doctor gasped, “Oh my god!” when looking at something on me.
Is there such a thing as Code Red? Or do that just say “All available doctors to Room 912. Stat.”
Code Red means a fire.
Well that sounds sorta scary!
So, what’s her status now? You always make me curious about how these cases turn out. What is/was her dx?
You’re going to be politically HIPAA correct and not tell us what the dx was, aren’t you?
It was ITP M(2) after all. Steroid responsive luckily.
Oh, good. Glad to hear she’ll be okay. Thanks for the new disease to look up — you’re like my daily dose of the Discovery Health Channel, without reruns (and also without my husband asking, “Are you going to watch that blood-and-gore stuff again tonight?”)
“Oh My God” is preferable to “Oops!”