NEW DEVELOPMENT - POSSIBLE LOW PLATELETS

[HaylesJohnson]

For anyone who has not been following our story so far and would like to know in case it makes more sense of what I am writing now... here is my last post - http://www.latitudes.org/forums/index.php?showtopic=18712

 

This afternoon, my son came home from school with a rash, inside his skin folds is raised and bumpy and itchy, much like the Scarlet Fever, and on his torso, around the front and back of his armpits there are masses of tiny pin pricks like little blood clots, some of these are in lines, some are spread all over the place - this rash did appear throughout the Scarlet Fever diagnosis also and the GP said it was likely just that his skin was sensitive so any rubbing would cause this reaction.

 

However, the doctor we saw this afternoon, is extremely confident that this rash is in fact indicative of a low platelet count. She also feels very strongly given the information on file from the last illness that is WAS in fact Scarlet Fever - and she is of the opinion that everyone here shares - the low ASO titer is irrelevant and the fact that it is descending would likely indicate that he has a weak immune system and his baseline is low!

 

She has ordered for bloods to be taken in the morning - she wants full bloodworks to get to the bottom of this immediately - she was incredibly supportive and when I advised her that the Pediatrician mentioned "post infection Neuro symptoms", she actually wrote PANS/PANDAS on the file!

 

Unfortunately however, these doctors ONLY work through our public hospital Outpatients clinic and all results are sent to the GP, so we will not be able to see her again. She actually did mention that Epstein-barr virus can cause this low platelet count, which Dr K did recommend in his email that we test for - I am wondering whether this could be a possibility!

[HaylesJohnson]

We actually just received results over the phone - Platelets seem to be fine, however DS has a low white cell count. This teamed with the petechial rash is confusing - we were told just to follow up with our GP, who as always is IMPOSSIBLE to get in to see. I do have the opportunity to call the minute they open the clinic in the morning to see if I am able to get him a last minute urgent appointment. I just don't know what any of this means or if its all related, I feel like we are going around in circles!

[thenmama]

Shoot- was just typing a response and my browser hiccuped it away... anyway, just wanted to let you know that my ds, and at least one other child on this forum, get petechial rashes that coincide with exacerbation. I'm trying to remember now if the other parent whose child has this had gotten any explanations for it from her doc-- maybe she'll chime in. Unfortunately we haven't figured our ds's out yet. There is at least one old thread about it, possibly a few, if you search for the term "petechiae" or "petechial" reash-- that's the term for purpura that is under a certain size, like the tiny little spots of blood you describe (almost like little freckles). You could try googling petechiae and purpura to see if it fits.

 

Anyway, pretty sure the person whose child gets the petechiae gets the outbreaks on the body-- my son usually erupts on the face neck, down into the chest. Docs look for a cutoff at the nipple line as a sign for more worrisome petechiae (those going below that point). My son's usually only eek over that point, but he also does not present as a typical case of the benign "fragile capillaries" that gets these outbreaks with pressure (e.g. coughing, vomiting, crying) because more often than not he doesn't get the outbreak with those things, and when he does get the outbreaks there isn't any change in those type of things. Plus they always coincide with PANDAS exacerbations.

 

Wanted to mention, too, that my ds is also prone to bumpy rash outbreaks during a flare. Multiple docs have been puzzled by these (and always in absence of positive strep, though there may have been a temporal relationship to his perianal strep, have to double check ). Our PANDAS doc saw him on the resolving side of one of these rashes, though, and thought it was scarlet fever, or strep-related b/c there was still enough of it for her to look at/feel. It is rough and sandpapery, usually on his torso. He gets other rashes, as well-- our mystery skin symptom boy.

 

I think I'd found a paper once about petechial rashes (on body, not palate) associated with strep. Will have to look for it.

 

Anyway, not an answer for you, but wanted you to know others here are experiencing some similar issues and are seeking explanations, as well. At least we can all share info and experiences and hopefully one of us will get some helpful info soon!