What can i do for bleeding of haemorrhoid after dropping of platelet count due to intake of nplate?
Patient: I have had ITP chronic for almost two years.  i also have Prostate Cancer and had 27 external beam radiation treatments. I was treated with predsione which did not work ,then given rubituxen . "Forgive my spelling" it work only a short time. I am now on Nplate which seems to work. My question is Nplate will bring my count up to at times over 300,000 then in 3or 4 days drop to 150  then in one or two days drop to the 30's. The trouble  is i have internal Hemerroids which bleed when count drops. I went to emergency and they gave me platelets. which stoped the bleeding then got a nplate shot . My Hematologist  told me not to go to hte emergency  anymore and get Platelets because it does more harm then good in the long run. my HGB stays normal from 13.3 to 14.3 and all others are with in accable range. Is there anything else I can try. My dr. wnts me to have my spleen removed ,I am 69 yrs. and not confortable with doing that except as a last reasort. what is you take on my situation? Doctor: Hi,Thanks for asking.Based on your clinical history and query, my opinion is as follows:1. Internal bleeding around hemorrhoids is OK. But if it were CNS bleeding, it can cause severe complications.2. Platelet count, if it falling due to spleen induced platelet destruction, then spleen needs to be removed, as spleen function is reduced due to continuous ongoing damage. 3. If you get the spleen removed, get yourself vaccinated.I would also advise spleen removal, if it is the main cause of low platelets. Antibody testing will confirm ITP. Any further queries, happy to help again.