Remicade/Imuran - low platelets

I checked my latest Platelet Count score and I got a 262 (acceptable range is 140-400 Thousand/uL) with my test. I'd check the units and acceptable range of your test (should be on the printout or digital test results) as they could be very different from mine.

Is it alarming? If it's unacceptable, then they'd immediately lower your dose of either the Azathioprine or Allopurinol (or stop those medications entirely) and it doesn't sound like they did. So, if no adjustments were made then you are probably fine. I'd certainly ask your doctor or nurse as it can't hurt to double-check and make sure they are monitoring your numbers and responding accordingly to changes. You're on the Aza + allopurinol combo (which I am not), so that could certainly impact your numbers and change what's okay on your results.

Your immunosuppressants work by reducing the rate in which WBC are produced within bone marrow. The reason we get routine blood tests is this. If the dose is too strong or your body metabolizes the medication too well then myelosuppression can occur and a number of your WBC, RBC, or Platelets can drop to unacceptable low levels (and that can happen at any time even after years of use). Often the dose can slightly be adjusted and you bounce back into range just fine. These are slow working medications and there's plenty of warning sign that you're heading toward out of range for one of your values.

I cannot find what is considered to be a dangerous low level. If you've been out of range for a series of months then they might've added Thrombocytopenia (low platelet count) to your file. I'd keep watching your numbers and make sure they pop back in range over time and don't continue dropping.

If it's real mild then you might see no symptoms at all.

If it's more moderate or severe than you might experience symptoms. Platelets are involved in clotting when you have a cut or bruise and as a consequence of having fewer of them you might have:

• Easy or excessive bruising (purpura)
  
• Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
  
• Prolonged bleeding from cuts
  
• Bleeding from your gums or nose
  
• Blood in urine or stools
  
• Unusually heavy menstrual flows

Source: www.mayoclinic.org/diseases-conditions/thrombocytopenia/basics/symptoms/con-20027170