age: 27
profession: software
diet: Non-vegetarian
It all started with the nosebleeds in the month of March 2017 with a frequency of one nosebleed in two weeks slowly increasing to once a week.
When I had my first Complete Blood Count(CBC) in April the counts were WBC: 4.0 HGB: 8.0 and platelets: 35k
Later I was referred to a hematologist and he initially diagnosed me as predominantly iron, folic acid and B12 deficient, and started with an infusion of 500ml of iron and weekly shots of B12 and daily intake of folic acid for a month.
But there wasn't any significant rise in my counts. Then later he did a bone marrow biopsy and found that there were no megakaryocyte cells in the marrow, which are responsible for platelets. All other tests including the chromosome came back negative. All my internal organ tests came back negative. So he says it is a case of ITP (Idiopathic thrombocytopenia purpura). He also suspected some kind of viral manifestation and he did a parvo virus test - that too was negative. At one point of time my platelets got down to 23k and then I was referred to jhons Hopkins university. Even they couldnt figure out the situation or the reason behind the absence of megakaryocytes. Later that week I was put on 40mg of prednisone for a week then 30 mg for next two weeks then 20mg for a week and right now am on 5mg. After using prednisone my WBC and HGB came up but not my platelets and so my doctor tappered the dose and as I reduced dose my haemoglobin came down.My counts last week were WBC: 6.0 HB: 10.8 and platelets : 30k. He also wants to me to have endoscopy and colonoscopy to find out the reason - why am unable to absorb B12 and iron. I had them sceduled on Sep'Friday 21st. In my colonoscopy they found there was slight inflammation in my small intestine.
I should also mention that I had haemoglobin low since my college days but not platelets and I used to have irregular bowl movements since then.
Right now am in US, Looks like low platelets started in India itself sometime in 2015. Because I remember a purple bruising kind of patch on my left arm when someone had accidentally hit me. But my question here is what could be the possible reason for bone marrow not to produce enough megakarocytes? Is this a case of bone marrow suppression? And what should I do from my end to help the situation in terms of diet or whatever. Because my doctor over here claims that he has done all the possible tests on me and says there is no medicine or food that will effect megakaryocytes and the only alternative is bone marrow transplantation which he says is not advisable unless its a life threatening situation.
