Thrombocytopenia: types, degrees of the disease, principles of treatment

Thrombocytopenia (low platelet count)

Thrombocytopenia is the condition when a low platelet count in the patient’s blood is observed. Platelets are blood cells that help to stop bleeding by coagulating and making plugs in case of blood vessel damage.

Thrombocytopenia can occur as the result of bone marrow involvement in case of problems with the immune system. It can also be a side effect of taking of certain medications.

Thrombocytopenia can occur in mild form and cause some signs or symptoms. In rare cases, the number of platelets can be so low that a dangerous internal bleeding occurs.

Signs and symptoms of thrombocytopenia can include:

superficial bruising on the skin that manifests as a rash with reddish-purple spots of punctual (petechiae) or medium size (purpura), usually on the shins;
prolonged bleeding from cuts;
gum or nose bleeding;

blood in the urine or stool;
abnormally complicated periods;
chronic fatigue;
enlarged spleen.

When you need to see a doctor

Book an appointment with a doctor if you have disturbing signs of thrombocytopenia.

bleeding that does not stop and requires emergency medical aid.

Emergency call

Causes of low platelet level

Thrombocytopenia means that less than 150 000 platelets per microliter of circulating blood were revealed. As long as every platelet lives of about 10 days, our body constantly renews the platelet stores, producing new platelets in the bone marrow.

Thrombocytopenia often has a genetic origin; it can be provoked by a number of reasons such as administration of certain medications or chronic diseases. The causes of platelet count drop can be as follows: increased level of platelet uptake in the spleen, platelet production drop or increased platelet destruction.

Captured platelets

Spleen is a small organ of the size of a fist located just below the chest, at the left of the abdomen. As a rule, spleen functioning is aimed at infection control and filtration of undesirable substances in blood. Enlarged spleen can capture too many platelets that results in reduction of the number of platelets in the blood flow.

Platelet production drop

Platelets are generated in the bone marrow. Factors that can reduce the generation of platelets include:

leukemia and other types of cancer;
some types of anemia;
virus infections, such as hepatitis C or HIV;

chemotherapeutic agents and radiation therapy;
alcohol abuse.

Increased platelet destruction

Certain conditions can make the body to consume or destroy platelets faster than it can produce them, which results in a shortage of platelets in the blood. Examples of such conditions are as follows:

Pregnancy – thrombocytopenia due to pregnancy is usually mild and improves soon after delivery.
Immune thrombocytopenia. Autoimmune diseases such as lupus and rheumatoid arthritis cause this type of thrombocytopenia. The immune system of the body erroneously attacks and destroys platelets. If the exact cause of this condition is not known, it is called idiopathic thrombocytopenic purpura. This type of disease most commonly affects children.
Bacteria in blood. Severe bacterial infections of blood (bacteriemia) can destroy platelets.

Thrombotic or thrombocytopenic purpura. This is a rare condition that occurs when small blood clots suddenly form all over the body using large numbers of platelets.
Hemolytic uremic syndrome. This rare condition causes an abrupt drop in the platelet level, destruction of erythrocytes and impaired renal function.
Medications. Some medications can reduce the number of platelets in blood. Sometimes a medication confuses the immune system and makes it to destroy platelets. Examples include heparin, quinine, sulfo-containing antibiotics, and anticonvulsants.

Complication

Dangerous internal bleeding can occur when the platelet count falls below 10,000 platelets per microliter.

Diagnostics

Blood test. A complete blood count measures the number of blood cells, including platelets, in a sample.
Physical examination including complete medical history. A doctor will look for signs of bleeding under the skin and examine the abdomen to see if the spleen is enlarged. He will also ask about the history of medical conditions of the patient, as well as the types of medications and supplements he/she has recently taken.

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

Treatment

Thrombocytopenia can last for days or years. People with mild thrombocytopenia may not need a treatment. For people who need a treatment for thrombocytopenia, it depends on the cause and severity of the condition.

If thrombocytopenia is caused by an underlying medical condition or a medication, addressing the cause may result in healing. For example, if a patient has heparin-induced thrombocytopenia, a doctor may prescribe another blood thinner.

Other treatment methods may include:

Blood or platelet transfusion. If the platelet count becomes too low, a doctor may replace the lost blood with a transfusion of platelets, blood plasma, and erythrocytes.
Medications. If the condition is related to an immune system problem, your doctor may prescribe medications to increase your platelet count. A corticosteroid may be the first choice drug. If that does not work, stronger medications can be used to suppress the immune system.

Surgery. If other treatments do not work, your doctor may recommend a surgery to remove the spleen (splenectomy).
Plasma exchange. Thrombotic thrombocytopenic purpura can cause a medical emergency requiring a plasma transfusion.

You will find the information on thrombocytopenia on our website: what it is, who can diagnose it, and what is the process of treatment. You can ask questions to specialists by phone, which number is indicated on the portal, or by making an appointment.

Article author - Tatiana Anikieieva, M.D.

Publication date: 20.05.2020

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