Update

Today's platelet count is 25, the highest it's ever been since Ibrahim was admitted to the hospital.  The plan for today is another transfusion in the evening and more steroids.  If his counts are still low in the morning, we might have Ibrahim transfered to the ICU for a whole blood exchange transfusion in an attempt to remove the anti-platelet antibodies.

St Jude has a visiting professor today, Dr James Bussel from Cornell University.  He is a world authority on pediatric thrombocytopenia and came to deliver a Grand Rounds seminar.  Dr. Bussel's talk was on experimental therapy of thrombocytopenia.  Our team of physicians will meet with him today to see what his experience is with this disease, and if he has any insight into our case. 

Specifically, if this is NAIT, then why is it not responding to Saira's platelets? If this antibody is transferred from the mother to the baby at birth, then how did Ibrahim have a normal delivery and circumcision without any bleeding?  And if there is an antibody in Ibrahim's blood, why has it not been neutralized yet by IVIG and steroids?  These are all questions that have yet to be answered.