posted
It's difficult. There is just not enough known about tick-borne infections and thrombocytopenia.
Treating the infection with antibiotics is the main thing that can be done. Doxycyline is the medication of choice, because it targets both Borrelia, Ehrlichia, Anaplasma and Rickettsiae (i.a. RMSF). It can be administered intravenously if needed (Pfizer; Vibramycin). The dosage should be at least 200mg per day, sometimes divided in two dosages.
If your friend fails to respond to Doxycyline other diagnoses should be considered. Heartland virus, for example, can cause severe thrombocytopenia and is also transmitted by ticks.
Sometimes intravenous gammaglobulin is used, but if it helps at all, it certainly isn't a fast cure.
"Therapy for thrombocytopenia requires treatment or removal of the underlying infection, in addition to maintenance of platelet counts and hemostatic function. However, identification and correction of a specific tick-borne infection is only possible if the infection is considered in the differential diagnosis of thrombocytopenia. Rapid treatment of the underlying infection should result in normalization of platelet counts. Ehrlichia, bartonella and RMSF should also be excluded in cases presenting with a clinical picture resembling TTP, particularly in those patients that prove difficult to manage, and in regions where the incidence of tick-borne illness is high. The efficacy of platelet transfusions in many of the tick-borne diseases is unclear and anecdotal (Van Eeden et al 1985). The value of prophylactic platelet transfusion may only be of transient benefit. Smith and coworkers (1975) showed that transfusing radiolabelled platelets into dogs infected with ehrlichia were destroyed in the spleen at an accelerated rate. Furthermore, exogenous platelet concentrates are probably best avoided in thrombotic-associated thrombocytopenia. In this condition, transfused platelets may become incorporated into platelet-fibrin thrombi and thus trigger a serious thrombotic event. The role of intravenous immunoglobulin, corticosteroids, plasmapheresis and even splenectomy in treating these patients has not been explored. Mild infections with babesia, for example, can be exacerbated by corticosteroids and/or splenectomy (Rosner et al 1984). Since thrombocytopenia contributes significantly to both morbidity and mortality associated with tick-borne diseases, further research directed specifically towards improving our understanding and guiding treatment of these platelet irregularities is required."
(This post is merely information, not medical advice.)
Posts: 109 | From The Netherlands | Registered: May 2014
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posted
Does your friend have hemolytic anemia as well?
And has treatment for Babesia specifically been considered? (clindamycin + quinine or azithromycin + atovaquone)
Intravenous gammaglobulin could be tried as well, but it's most defenitely not a panacea.
Posts: 109 | From The Netherlands | Registered: May 2014
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I hope your friend's health will improve soon and I'm looking forward to your update.
Posts: 109 | From The Netherlands | Registered: May 2014
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posted
I'm sorry to hear her health is this bad. It's a very complicated situation.
I'm not familiar enough with the healthcare system in the US to advise you. I hope another member can share his/her experiences.
Posts: 109 | From The Netherlands | Registered: May 2014
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