Description

Thrombocytopenia is a condition in which you have a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that help the blood to clot. Platelets stop bleeding by clumping and forming plugs in blood vessel injuries.

Thrombocytopenia can occur as a result of a disorder of the bone marrow, such as leukemia or an immune system problem. Or it can be a side effect of certain medications. It affects both children and adults.

Thrombocytopenia may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

Symptoms

Thrombocytopenia signs and symptoms may include:

  • 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 bottom of the legs
  • Prolonged bleeding from cuts
  • Bleeding from the gums or nose
  • Blood in the urine or stools
  • Unusually heavy Menstrual flow
  • Fatigue
  • Enlargement of the spleen

When to see a doctor

Make an appointment with your doctor if you have signs of thrombocytopenia that worry you.

Bleeding that does not stop is a medical emergency. Seek immediate help for the bleeding that cannot be controlled by the usual first-aid techniques, such as the application of pressure to the area.

Causes

Thrombocytopenia means that they have less than 150,000 platelets per microliter of circulating blood. Because each platelet lives only about 10 days, normally, the body renews its count of supply continuously for the production of new platelets in the bone marrow.

Thrombocytopenia is rarely inherited, or it can be caused by a number of medications or conditions. Whatever the cause, circulating platelets are reduced by one or more of the following processes: the capture of platelets in the spleen, decreased platelet production or increased destruction of platelets.

Entrapment of platelets

The spleen is a small organ about the size of your fist, located just below your rib cage on the left side of his abdomen. Normally, the spleen works to fight infection and filter unwanted material from your blood. An enlargement of the spleen — which can be caused by a number of disorders can accommodate too many platelets, which decreases the number of platelets in the circulation.

The decreased production of platelets

Platelets are produced in the bone marrow. Factors that can decrease the production of platelets include:

  • The leukemia and other cancers
  • Some types of anemia
  • Viral infections, such as hepatitis C or HIV
  • Chemotherapy drugs and radiation therapy
  • The excessive consumption of alcohol

Increased breakdown of platelets

Some conditions can cause your body to use up or destroy platelets more quickly produced, which leads to a shortage of platelets in the bloodstream. Examples of such conditions include:

  • Pregnancy. Thrombocytopenia caused by pregnancy is usually mild and improves soon after giving birth.
  • Thrombocytopenia immune. Autoimmune diseases, such as lupus and rheumatoid arthritis, the cause of this type. The body's immune system mistakenly attacks and destroys platelets. If the exact cause of this disease is not known, it is called idiopathic thrombocytopenic purpura. This type is most often affects children.
  • The bacteria in the blood. Serious bacterial infections involving the blood (bacteremia) can destroy platelets.
  • Thrombotic thrombocytopenic purpura. This is a rare condition that occurs when small blood clots, suddenly throughout your body, the use of large numbers of platelets.
  • Hemolytic uremic syndrome. This rare disorder causes a sharp drop in platelets, the destruction of the red blood cells and impairs renal function.
  • Drugs. Certain medications can reduce the number of platelets in the blood. Sometimes a medication confuses the immune system and causes it to destroy platelets. Examples include heparin, quinine, sulfa-containing antibiotics and anticonvulsants.

Complications

Dangerous internal bleeding can occur when the platelet count falls below 10,000 platelets per microliter. Although it is rare, severe thrombocytopenia can cause bleeding in the brain, which can be fatal.

Diagnosis

The following can be used to determine whether you have thrombocytopenia:

  • Blood test. A complete blood count determines the number of blood cells, including platelets, in a sample of your blood.
  • Physical examination, including a complete medical history. Your doctor will look for signs of bleeding under the skin, and feel your abdomen to see if the spleen is enlarged. He or she will also ask about the diseases that you've had, and the types of medications and supplements that you have taken recently.

Your doctor may suggest other tests and procedures to determine the cause of your condition, depending on your signs and symptoms.

Treatment

Thrombocytopenia can last for days or years. People with mild thrombocytopenia may not need treatment. For people who need treatment of the thrombocytopenia, the treatment depends on its cause and how severe it is.

If the thrombocytopenia is caused by an underlying condition or medication, addressing the cause can be the cure. For example, if you have heparin-induced thrombocytopenia, your doctor may prescribe a different anticoagulant.

Other treatments may include:

  • Blood or platelet transfusions. If your platelet level becomes too low, your doctor can replace lost blood with transfusions of packed red blood cells or platelets.
  • Drugs. If your condition is related to an immune system problem, your doctor may prescribe drugs to boost your platelet count. The first-choice drug may be a corticosteroid. If that doesn't work, stronger medications may be used to suppress your immune system.
  • Surgery. If other treatments don't help, your doctor may recommend surgery to remove the spleen (splenectomy).
  • The Plasma exchange. Thrombotic thrombocytopenic purpura may result in a medical emergency that requires the exchange of plasma.

Lifestyle and home remedies

If you have thrombocytopenia, try the following:

  • Avoid activities that may cause injury. Ask your doctor what activities are safe for you. Contact sports, such as boxing, martial arts and football, they have a high risk of injury.
  • Drink alcohol only in moderation, if at all. Alcohol decreases the production of platelets in the body. Ask your doctor if it is okay to drink alcohol.
  • Use caution with over-the-counter medications. Over-the-counter pain medications, such as aspirin and ibuprofen (Advil, Motrin IB, others) can prevent platelets from working correctly.

Preparing for your appointment

Start by seeing your primary care physician, who can handle the majority of cases of thrombocytopenia. In certain situations, he or she may refer you to a specialist in blood disorders (hematologist).

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as restrict your diet.

Make a list of:

  • Warning signs that you may have noticed, as any unusual bleeding or bruising, or any kind of rash, and when they began
  • Key personal information, including recent illnesses or medical procedures, such as a blood transfusion, the major stresses or recent life changes
  • All the drugs, vitamins, and other supplements you are taking, including dose
  • Questions to ask your doctor

Take along a family member or a friend, if possible, to help you remember the information that you receive.

By thrombocytopenia, questions to ask your doctor include:

  • How many of the platelets in my blood?
  • It is my platelet count in dangerously low levels?
  • What is the cause of my thrombocytopenia?
  • I need more tests?
  • Is my condition likely temporary or chronic?
  • What are my treatment options?
  • What will happen if I do nothing?
  • Are there any restrictions that I need to follow?
  • There is printed material I can have? What sites do you recommend?
Symptoms and treatment of Thrombocytopenia (low platelet count)