Hi all,
Recently had a follow up with my specialist, first one since my PSC diagnosis. My LFTs are still abnormal, but stable and are considerably better on Urso then beforehand.
A recent lot of bloods has shown a very low platelet count, RBC and WBC both low, RBC measuring 80 (normal is above 150).
It has me a little worried, like I needed anything else to worry about haha! But has anyone else had or heard of any one with PSC developing a low platelet count?
Thanks
Travis
Also, I should add, when diagnosed, there was some slight scarring of the liver and my Gastro said that it was all very early stages still.
Thanks
Travis, in the eight blood tests I have had since March 21, 2015, all eight showed low platelets, ranging from about 80 to 131.
In my best Alfred E. Neuman impression, "What, me worry?"
I meet with my liver doc in early August, and plan on a discussion of what the finding reveal from these tests.
Jeff
Hi TD,
Low platelets are heavily associated with chronic liver disease for two reasons.
1) As Dennis mentioned, portal hypertension caused by liver damage -> splenomegaly (enlarged spleen) -> increased platelet sequestration (unnecessary breakdown of platelets). Platelets and red blood cells naturally "die" in the spleen, but if enlarged, the organ will do too much of this.
2) An often overlooked reason for low platelets is the synthetic functioning of the liver. Your liver produces a hormone called Thrombopoietin, which stimulates the production of platelets in the bone marrow. If the liver is not adequately producing this hormone, the bone marrow is not told to do its job, and platelet levels drop. This explains continued thrombocytopenia (low platelets) in liver diseased patients who have undergone a splenectomy.
What to ask your doctor next:
Ask if splenomegaly (enlarged spleen) was noted on any of your imaging tests; this will explain a lot.
Request a Prothrombin Time and a Partial Thromboplastin Time blood test, in addition to regular platelet monitoring. These tests will assess additional functions of your liver relating to blood clotting proteins, and will be able to give you and your doctor a clear picture of how likely you are to experience a bleed, for example.
Finally, in the production of all clotting proteins, vitamin K is a very important nutrient. It is a fat-soluble vitamin that many people with cholestatic disease are deficient in, and can create problems like prolonged blood clotting. I would ask your doctor about possible vitamin K supplementation if your Prothrombin Time is abnormal.
I know just how scary and annoying every "abnormal" test is. Unfortunately, the answer is usually just to keep testing, and to embrace the "new normal" and the small victories that come with it.
Wishing you the very best of luck!
I totally support Celiza9’s information. I live in Cali and currently being treated by UC Davis. The key is to stay informed. You are your BEST advocate.
Yay Davis! I have an uncle there in plant cell biology. Best of luck with treatment.
Squid7 said:
I totally support Celiza9's information. I live in Cali and currently being treated by UC Davis. The key is to stay informed. You are your BEST advocate.
I know this is an old forum but I recently have had a low platelet count as well 38. I guess low enough I am going through the transplant evaluation process soon as well. My meld score is still very low as well as my liver numbers but my blood is worrying me. I have been lightheaded and dizzy for awhile now what I thought was encepelathopy but I guess could be due to my low blood. Can anyone comment on this? Also I have been very fatigued and lethargic lately. I am only 31 so I probably try to do more than I can with a transplant on the horizon hopefully I guess I better slow down and rest so I can live a long life. Thanks for anyone’s comments and support.
Freddy, get word to your doc asap-make sure it is a liver specialist, not just a GI. Any platelet count below 50 can be dangerous. Your body's ability to clot is pretty compromised, so you might bleed/bruise a lot more easily.
Jeff
Yes it is a liver specialist
Freddy, it's hard to get the context of your bloodwork without some other numbers. How was your liver panel and the rest of your CBC, specifically hemoglobin and RBC count? Lightheadedness could be something as simple as anemia, or something a little more concerning, like encephelopathy.
38 is low, for sure, but it could be worse! Have you gotten a PT or a PTT to check clotting time?
Freddy said:
I know this is an old forum but I recently have had a low platelet count as well 38. I guess low enough I am going through the transplant evaluation process soon as well. My meld score is still very low as well as my liver numbers but my blood is worrying me. I have been lightheaded and dizzy for awhile now what I thought was encepelathopy but I guess could be due to my low blood. Can anyone comment on this? Also I have been very fatigued and lethargic lately. I am only 31 so I probably try to do more than I can with a transplant on the horizon hopefully I guess I better slow down and rest so I can live a long life. Thanks for anyone's comments and support.
That plt number is low. You need to find out the cause. Also, sample mishandling may cause low number of plt. And as Celiza9 said, you also need PT and INR.
Don't worry too much about plt number. Keep an eye on any new bruise on your body. If you need surgery now, transfusion will help you go through it.
My ast is 111, alt 86, bili 2.1, and alk 286. My RBC are 4.18 and hemoglobin is 13.2. INR is 1.3 and protime is 14.2. I have been treated for prior symptoms as encephalopathy and I am currently taking lacutose and Xifican for brain fog. I had an albumin infusion last week to try to help push remaining fluid out of me they also said might help encepelathopy. The last few days feels more like light headedness and dizziness. I am being evaluated for transplant soon so hopefully can have a live donor so I don’t have to wait a long time but I guess only time will tell. These day to day issues are hard to deal with though. Appreciate the support and advice.
Freddy, I learned something 10 years ago in dealing with UC and resulting ileostomy-focus long term. You still have to get through the day to day stuff-you're right, it is hard to do. But focusing long term helped keep me mentally grounded and focused to help me get through the day to day "stuff".
I am using this same lesson to help with my psc.
Freddy said:
My ast is 111, alt 86, bili 2.1, and alk 286. My RBC are 4.18 and hemoglobin is 13.2. INR is 1.3 and protime is 14.2. I have been treated for prior symptoms as encephalopathy and I am currently taking lacutose and Xifican for brain fog. I had an albumin infusion last week to try to help push remaining fluid out of me they also said might help encepelathopy. The last few days feels more like light headedness and dizziness. I am being evaluated for transplant soon so hopefully can have a live donor so I don't have to wait a long time but I guess only time will tell. These day to day issues are hard to deal with though. Appreciate the support and advice.