Crohn's Disease Forum » Parents of Kids with IBD » Platelets- questions

08-14-2014, 11:59 AM   #1
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Join Date: May 2014
Platelets- questions

Please share what you know. To determine remission by bloodwork, must the platelets be within normal range? Do you use platelets to monitor for inflammation? How high is too high?

08-14-2014, 12:04 PM   #2
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Join Date: May 2014
While I am asking-- what would you make of this? Sed rate was high (close to70) but came down to 27. Normal is 0-15. CRP was normal 7 (with normal up to 9) and came down to 1.5.

How do you figure out which inflammatory markers are reliable for your child and which ones are not? Is that something you don't know unless you have blood work done the same week as diagnostic tests such as colonoscopy and EGD?
08-14-2014, 12:46 PM   #3
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Location: Ontario

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Can't help you with the platelets but, re the inflammatory markers...

When they are high, I believe you can trust that they are reflecting inflammation is present.

If they are within normal ranges, this may not be as reliable an indicator that there is no inflammation. There are many here who have had normal CRP/ESR but other tests have shown inflammation is present.

I did ask my son's GI how reliable CRP and ESR are in flagging inflammation, his answer was that historically my son's inflammatory markers have been an indicator so he would consider them to be indicators in the future.

Prior to being diagnosed, my son's CRP and ESR were quite high. His treatment for two years was only exclusive and then supplemental EN - this took away all symptoms, however, MREs continued to show inflammation. During this time, his inflammatory markers were much better than pre-dx but were still elevated. Once he started on remicade, his inflammatory markers dropped considerably (to low levels of normal).

So in my son's case, it's been past experience that's determined that they are reliable.

As far as WHICH one is more reliable, the two reflect inflammation differently. ESR takes long to rise and lower; CRP gives you a much more immediate indication. In the past, my son has had normal CRP but elevated ESR - but, if I remember correctly, in those instances, I was always able to look back and tie the elevated ESR to some injury. The next test would usually show a lowering of the ESR (even if not quite at normal levels yet). I believe it can take weeks for ESR to move up and down. FWIW, my son's GI no longer tests my son's ESR regularly but tests CRP at every other remicade infusion.

Other than comparing tests, as you suggested (ie lab work and MREs), until you see a trend, I don't think there's any other way to know which are reliable.
Tess, mom to S
Diagnosed May 2011

May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil

Last edited by Tesscorm; 08-14-2014 at 01:33 PM.
08-14-2014, 12:51 PM   #4
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I've never heard of platelets being used to monitor inflammation, but my daughter has perfect bloodwork (always!) so perhaps someone else can answer that.

In terms of ESR and CRP, it's best to look at the trend over time. My daughter's ESR, for example, will rise when she's flaring but always is within the normal range. Her CRP never rises. So we don't really pay much attention to her inflammatory markers, though her doctors do still check them.

It looks like your son's ESR is falling and so is his CRP, which is good! Everything is going in the right direction, though it may take some time for his bloodwork to go back to normal.
Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
08-14-2014, 05:11 PM   #5
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Join Date: May 2014
Location: DFW, Texas

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We had super high platelets (don't have the number in front of me) and out GI said it wss from the steroid use.
Mom to: 15 year old boy
Crohn's in stomach, small intestine, large intestine, and perianal disease
Diagnosed April 2014, at age 13

Currently taking:
Remicade 10mg/kg every 6 wks
Methotrexate 7.5 mg/wk

previous meds:
6mp 50mg
Prednisone 30 mg
08-14-2014, 05:41 PM   #6
my little penguin
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Most docs try to get inflammtory markers within the normal range .
There is clinical remission where bloodwork /imaging /biopsys are all within the normal limits - there is a pediatric crohn's global assessment
It's older but gives you an idea

DS has similar dx as maya ( JSpA plus crohn's ) - his bloodwork is typically very close to normal -his platelets and sed rate does rise when he is flaring .
After three years we know the numbers will
Match his symptoms .

To get your child's - track the numbers over time with notes on symtpoms at each time .
Them you can see their trend .
DS - -Crohn's -Stelara -mtx
08-14-2014, 05:44 PM   #7
my little penguin
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08-14-2014, 06:33 PM   #8
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When my daughter was very sick her platelets were very high, more than 500 they got between normal range after treatment. Now between 220 -240. We do not use platelets to monitor inflammation. Lower than normal can be from meds, autoimmune disorders that attack platelets etc. High count, A type of anemia, certain infections, allergic reaction, certain meds etc. I am not happy unless sed rate is less than 15 for my kid. In our case we get blood work every 8 weeks and monitor sed rate every test. I second what was said above, combination of blood, mri and biopsies good results to determine remission.
Mom/ Girl 19
dx 2011 crohn's in terminal ileum, peri-anal
Prior Meds Asacol, Prednisone, nexium
Current meds.
Remicade since Nov. 2012
5000 Vit. D, Multi-Vitamins with Iron
Currently in REMISSION :dance

Mom/ 16 boy
Amplified musculoskeletal pain
Prior. Prednisone, sulfasadine,
Currently. Celebrex, gabapentin, amitriptyline.
08-14-2014, 09:48 PM   #9
Senior Member
Join Date: May 2014
Thanks for the detailed responses. MLP- those links have very helpful info, and I have not read those in the past.

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