Peter Lindsay – in his own words
I am 77 years old, a non-smoker, and might have a glass of wine from time to time. I was first diagnosed with ITP in 2015, as far as I am aware defined as having a platelet count of <150. This was picked up on a routine full blood count prior to starting treatment for a fungal infection. Platelet count on my first Haematology consultation was 104. All blood parameters including viral serology were negative. A staging CT scan of neck, chest and abdomen did not show any evidence of pathological lymphadenopathy. Three months later, with no medication, my platelet count was 142. I was then scheduled for review one year later, and then annual blood tests.
Fast forward to October 13th 2020 when my annual platelets count was 95 ( usually slightly above 100 ). My GP advised me to have an additional routine test within a three-month period. I had had my flu vaccine on Oct 10th, so that may have a slight negative impact on my platelet count. During the intervening five years I gave little thought or importance to platelets. In my mind, ITP was of little consequence. I did not declare the condition to my travel insurance company, my thinking being, ' my platelets are slightly lower than the norm, so what?'.
On November 25th 2020 I was admitted to hospital with acute urinary retention and UTI. I was catheterised,( two attempts, ouch, ouch), and there was some amount of bleeding around the site of the catheter but there was no haematuria. A few hours later blood test results came back and my platelet count was 6. This all happened in the walk-in A&E department and the duty medic seemed less perplexed once I had quickly offered my ITP history. Whilst I am much wiser now, thanks to the ITP Support Association, I had not linked infection with a possible drop in platelet count.
I was started on a course of Co-amoxiclav to deal with the infection,(the previous four days leading to admission I had been on Nitrofurantoin), and Prednisolone 60mg daily for the ITP. On Dec 4th my platelets were 342 decreasing to 122 on Feb 9th, by which date my Prednisolone dose had been tapered to 10mg per day. This was back around my normal platelet count.
I had my first Pfizer jab on Jan 23rd and there seemed to be no effect on my weekly platelet counts of around 120 until Feb 16th when they dropped to 22. A few days earlier, on Feb 12th, almost three weeks after my Pfizer jab, I woke in the early hours of the morning lightheaded, shivering, aching all over and had had a night sweat. The following day I was fatigued, no appetite, a headache but no fever. The following day I was almost back to normal. My suspicion was that this dramatic drop in platelet counts was a reaction to the Covid vaccination. My haematologist treated this episode as a relapsed ITP and started me on a four-day course of Dexamethasone 20mg with a view to proceeding with Rituximab if I relapsed again. My platelets were 220 after the four days on Dexamethasone. A scheduled bone marrow biopsy around this period showed nothing abnormal. My second Covid jab was brought forward in case I had to start Rituximab therapy.
I have had no further medication and my platelets have now, August 6th, settled to levels between 100 to 120 with a drop to 74 around the time of my second Pfizer jab, and 69 after a heavy cold.
In summary, I have asked for my story to be included on the website as an illustration of how infections, vaccines and viruses might affect platelet counts. I my particular case, my normal platelet level seems to be just above 100, with a likely negative impact due to future vaccines, infections and viruses, such as the common cold. I will be quick to deal with future infections and try to organise a platelet count near such events. I will be taking my ITP more seriously in the future.