Post Viral Thrombocytopenia and Hematuria

Q: Hi, I got black urine twice in a day. So I went to a gynecologist. She instructed me to get 2 reports of urine and blood. Urine report came normal for two days. But platelet count was low. Since last 2 months, I got fever 2 times with cold and shivering. After few days of 2nd fever, I had diarrhea 5 times a day. After 15 days, I got black urine. 

My reports says:
Blood:
Hemoglobin: 10 gm%
Total RBC count: 3.73 mil/cu.mm
Total WBC count: 10600/cub.mm
Platelet count: 1.36 lac/cu.mm

Smear study :
RBC: mild hypochromic  normocytic
WBC: leukocytosis (mild)
Platelet: thrombocytopenia (mild)
No malarial parasite. No dengue.
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Urine Analysis:
Physical:
Quantity: 20 cc
Color: yellow
Deposit: absent
Transparency: hazy
Reaction: acidic
Specific gravity: q.i.

Chemical:
Albumin: trace
Sugar: absent
Bile salts: absent
Bile pigments: absent

Microscopic (after centrifugation at 2000 r.p.m. for 5 minutes):
Pus cell: 1-2/h.p.f.
Red cell: 80-100/h.p.f.
Epithelial cell: 2-5/h.p.f.
Casts: absent
Crystal: absent
Amorphous: absent
Monilla: absent
Trichomonas vaginalis: absent.

Then after seeing this report that lady doctor gave me some medicines. After a day she told me to repeat the urine test. In the second urine test, following changes were noted:

Transparency: slight turbid
Color: pale yellow.
Deposit: present.
Pus cell: occasional /h.p.f.
Red cell: 19-20/h.p.f.
Epithelial cell: 1-2/h.p.f.

Then after seeing this, she told me to continue medicines that she gave and added a few more. But she didn’t tell me what was the reason for it. She was not clear about it. Today I feel very week, light headache and head is kind of revolving. Please tell me what may be the exact reason for such symptoms?
-By: Radhika, 21 years old female.

Reply:

After going through your reports carefully, it can be inferred that the major event responsible for your symptoms was reduction in your platelet number.  This can be explained as a case of post viral thrombocytopenia.

Sometimes, after a viral infection, the platelet counts reduce considerably. This condition is called thrombocytopenia. This happens, probably, because as our body produces antibodies against the virus, it may also produce some antibodies against any of its own cells (autoantibodies).

Your platelet counts were considerably reduced after your infective illness.

Thrombocytopenia could have been a cause of hematuria, that is blood in urine. This is because the blood becomes thin and vulnerable to bleed.

Your subsequent reports have already shown an improvement in your platelet counts. This suggest that your body is recovering.

You need to keep an eye on your platelet counts. Get your lab tests for blood cells repeated frequently. The counts should improve gradually to get normal eventually.

Your present symptoms of headache and weakness may be due to low hemoglobin levels in your blood.

For that, add some iron and protein supplement in your diet on an regular basis.

What medications are you taking right now? You may let us know for further clarity.

Take Care,

Buddy M.D.