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Thrombocytopenia
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Thrombocytopenia is a blood condition in which there is a very low blood platelet count. Platelets are also called thrombocytes and are important in the clotting of blood. Platelets are small cells that clump together to form a blood clot and stop bleeding spots in the body. Thrombocytopenia can happen whenever a person has leukemia or an immune problem or as a primary condition involving the platelets. Certain medications can lower the platelet count. A low platelet count can be serious or mild. If the platelet count drops below 10,000 per microliter, spontaneous and sometimes fatal bleeding can occur.
Symptoms and signs of a low platelet count include excessive bruising with little provocation, petechiae, which are small pinpoint spots of blood on the skin, excessive bleeding from any cuts or scrapes, spontaneous gum or nose bleeding, blood in the stools, blood in the urine, heavy menstrual bleeding or profuse bleeding following dental work or surgical procedures.
Thrombocytopenia can be a medical emergency so that you need to seek medical attention if you have bleeding that won't stop or any of the above symptoms to a degree of severity that appears dangerous. A normal platelet count is between 150,000 and 450,000 platelets per microliter and if it drops below 150,000, you can begin to see problems. Platelets last about ten days in your system so if the platelets aren't being made, you have ten days in which to seek medical attention to give you more platelets.
The causes of platelet lowering in the body include trapping of platelets in the spleen. The spleen can be enlarged and can hold onto platelets, not allowing them to be filtered through the system. There can be a reduced production of platelets in the bone marrow. Any disease that affects the bone marrow can affect the amount of platelets made. This can include toxins, chemotherapy, alcohol consumption or leukemia. Platelets can also be destroyed more rapidly than normal. Such conditions that cause an increase in the breakdown of platelets include:
- Pregnancy, which usually causes mildly low platelet counts
- Autoimmune diseases, which can cause your body to attack otherwise healthy tissue and reduce platelet count
- Idiopathic thrombocytopenic purpura, where the platelets themselves are attacked by the immune system
- Bacterial infections in the bloodstream can cause platelets to diminish secondary to the infection
- Thrombotic thrombocytopenic purpura, where small blood clots are formed throughout the body that use up available blood platelet counts
- Hemolytic uremic syndrome is a rare condition that causes direct destruction of red blood cells
- Medications can cause thrombocytopenia by interacting with the immune system and causing it to destroy your platelets. These medications can include heparin, quinine, gold salts, anticonvulsants and sulfa antibiotic drugs.
Doctors can diagnose thrombocytopenia by checking a complete blood count and determining the amount of platelets within the blood. A physical examination can look for bruising and bleeding. The doctor can also check to see if your spleen is enlarged. A bone marrow evaluation can check to see if there is something in the bone marrow that can interfere with platelet construction.
The treatment of thrombocytopenia depends on the degree of platelet loss. Mild thrombocytopenia often does not need any treatment, especially when the cause is as simple as pregnancy. If the thrombocytopenia is severe, there are several treatments available. You need to have the doctor identify the actual cause of the low platelet count before active treatment can begin. You can receive blood transfusions in order to replace the missing platelets. Platelet transfusions alone are possible. If you have idiopathic thrombocytopenic purpura, you may need to take corticosteroids to block the immune system from killing platelets. If this doesn't work, the doctor may decide to remove the spleen so as to prevent platelets from getting blocked within the spleen.