Lowest Platelet Count Ever (And She Was 97 Years Old)!

A normal platelet count  is between 150K-450K  My lowest platelet count ever was in a 97 year old lady with a platelet count of 1K from a suspected immune mediated peripheral destruction. This is a severe case of thrombocytopenia.  Wow!  She lived.

The differential diagnosis of a low platelet count is quite broad.   As a hosptialist, the most common causes of a low blood platelet I see are from are sepsis, chronic liver disease and associated splenomegaly from alcohol abuse or hepatitis C, drug mediated reactions, heparin induced thrombocytopenia (HIT), viral bone marrow suppression (such as parvovirus in sickle cell patients),  multiple myeloma and other cancers, myelodysplastic syndrome,  lupus, idiopathic thrombocytopenia purpura (ITP) and thrombotic thrombocytpenia purpura (TTP). In addition, there are many other causes of really low platelet counts I've seen through the years not listed here.

Remember your physiology.  Patients with low platelet counts tend to bleed around their gums and get the spotted, nonblanching rash on their extremities (called petechia) while patients with a coagulopathy tend to develop spontaneous hematomas in open spaces, such as a hemarthrosis.  I'n my 97 year old patients, it's a good thing she wasn't on warfarin!  See other wild clinical experiences through my years as well.




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11 Outbursts:

  1. 0.7 K. Leukemic. Died, but several months later.

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  2. We see platelet counts <1 at least once a month. We don't transfuse until they're <10 usually, and for some people they can easily get from 10 to 1 in 24 hrs. We had one lady who was constantly popping out platelets of 10 and hgbs of 4 and such. She was extremely refractory to transfusions after tons of chemos, an auto bmt, and tons of radiation. She really needed an allo BMT, but there were no donors to be found given her race. No one has BMT beat on the CBCs ;)

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  3. That lady was constantly having platelets of 1, that should say.

    Oh yeah, also fun when we run out of platelets and we get to decide if our patient at 6 or our patient at 4 gets the last bag. *sigh* Luckily, that usually doesn't last long.

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  4. hopefully she wore a helmet at all times...

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  5. You don't typically transfuse platelets for ITP (what I assume you thought this woman ended up having).

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  6. unless the platelet count is <1k. you know. on account of the dying thing while the steroids are working?

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  7. i had a platelet out of 1,000. im only 15. and im still alive.

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  8. You think a platelet count of 1K at 15 is bad? Ha! I had a platelet count of this when i was 4 and a half. They seriously don't know why I'm still alive.

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  9. My father recently died from AML. He came home from the hospital with a terminal diagnosis. His platelet count was 6 in the hospital his blast cell percentage was 89%. He had coffee, a couple of spoonfuls of oatmeal a creamsicle on Monday, he died approx. 4:49am Wednesday morning. He managed to have approx. 2 1/2 years of remission from induction of Mylotarg. In Dec. his AML returned the Dacogen did not help with remission the most recent time.

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  10. I had a platelet count of 200 when I was 4 years old and I'm 14 now and loving life. Thank you to all who helped save me!

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  11. I have a platelet count of 55 and I'm doing ok.

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