Thrombocytopenia (low platelet count)
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Thrombocytopenia is a condition characterized by a low count of blood platelets, which are also known as thrombocytes. These colorless blood cells play a crucial role in clotting, clumping and forming plugs to stop bleeding in case of blood vessel injuries.
Thrombocytopenia can affect individuals of all ages, from children to adults. The condition can stem from various causes, including bone marrow disorders like leukemia, immune system dysfunction, or as a side effect of certain medications.
While some cases may be mild with few noticeable signs or symptoms, severe instances can result in dangerously low platelet counts leading to internal bleeding. Fortunately, treatment options exist to manage thrombocytopenia and its complications.
Symptoms
Signs and symptoms of thrombocytopenia may comprise:
- Bleeding from your nose or gums
- Bleeding in stools or urine
- Extended bleeding after wounds
- Exceptionally heavy menstrual flows
- Profound or easy bruises (purpura)
- Skin bleeding superficially that causes a rash of tiny reddish-purple spots (petechiae), commonly on the lower limbs
- Enlarged spleen
- Fatigue
If you notice any worrying signs of thrombocytopenia, it’s important to schedule an appointment with your doctor. Remember, persistent bleeding that you can’t stop requires immediate medical attention. Seek help right away if standard first-aid techniques like applying pressure aren’t working.
Causes
Thrombocytopenia occurs when you have fewer than 150,000 platelets per microliter of blood. Platelets have a short lifespan of about 10 days, so your body regularly replenishes them by producing new ones in the bone marrow. This condition is rarely inherited and is often caused by various medications or medical conditions. Regardless of the cause, thrombocytopenia typically involves one or more of the following processes: reduced platelet production, increased platelet destruction, or platelet entrapment in the spleen.
Trapped platelets
The spleen, roughly the size of your fist, resides below your rib cage on the left side of your abdomen. Its primary functions include fighting infections and filtering out unwanted substances from your blood. However, when the spleen enlarges due to various disorders, it can trap excess platelets, leading to a decrease in circulating platelet count.
Decreased platelet production
Platelets are manufactured in your bone marrow. Factors that can reduce platelet production include:
- Leukemia and other malignancies
- Some forms of anemia
- Excessive alcohol intake
- Viral diseases, like HIV or hepatitis C
- Chemotherapy and radiation therapy
Increased platelet destruction
Certain conditions can result in your body using up or destroying platelets more quickly than they are produced, resulting in low platelet levels in your bloodstream.
Examples of the conditions encompass:
- Medications. Certain drugs can cause your blood’s platelet count to drop. Occasionally, a medication throws the immune system off, making it attack platelets. Heparin, quinine, antibiotics including sulfa, and anticonvulsants are a few examples.
- Pregnancy. Pregnancy-related thrombocytopenia is often mild and becomes well quickly after delivery.
- Bacteremia. Platelets can be destroyed by severe blood-borne bacterial infections, or bacteremia.
- Immune thrombocytopenia. This kind is brought on by autoimmune illnesses including lupus and rheumatoid arthritis. Platelets are unintentionally attacked and destroyed by the immune system. This disorder is referred to as idiopathic thrombocytopenic purpura if the precise cause is unknown. Kids are more frequently impacted by this kind.
- Thrombotic thrombocytopenic purpura. This uncommon illness is characterized by the sudden formation of tiny blood clots throughout the body that deplete platelets significantly.
- Hemolytic uremic syndrome. This uncommon illness damages red blood cells, sharply lowers platelet counts, and compromises renal function.
Diagnosis
The following can help determine if you have thrombocytopenia:
- Physical examination with a thorough medical history included. In addition to examining your abdomen to check for enlarged spleen, your doctor will check for any indications of bleeding beneath your skin. Along with inquiries regarding ailments you’ve had, he or she will also inquire about the kinds of drugs and supplements you’ve recently taken.
- A blood test. The amount of blood cells, including platelets, in a sample of your blood is ascertained by a complete blood count.
Depending on your signs and symptoms, your doctor may recommend additional tests and procedures to identify the cause of your condition.
Treatment
Thrombocytopenia can endure for varying durations, ranging from days to years. Mild cases may not necessitate treatment. However, managing thrombocytopenia depends on its underlying cause and severity. Addressing the root cause, such as an underlying condition or medication, may alleviate thrombocytopenia. For example, if heparin-induced thrombocytopenia is the issue, your doctor might recommend an alternative blood-thinning medication.
Other treatment options may include:
- Prescription drugs. If your condition is associated with an immune system problem, your physician may suggest medication to boost your platelet count. Initially, a corticosteroid might be the preferred choice. If this proves ineffective, stronger medications to suppress your immune system may be utilized.
- Platelet or blood transfusions. Your doctor may restore lost blood with transfusions of packed red blood cells or platelets if your platelet count becomes too low.
- Exchange of plasma. Plasma exchange may be necessary in the event of thrombotic thrombocytopenic purpura, which is a medical emergency.
- Surgical procedures. In the event that non-operative measures prove ineffective, your doctor may suggest a splenectomy.
