Thrombocytopenia: Low Blood Platelet Count
Authored by Dr.Shyam A Rathi
Introduction Thrombocytopenia is a state of low blood platelet count causing a variety of symptoms and health issues. The normal blood platelet count ranges from 150,000 to 400,000 per microliter of circulating blood while Thrombocytopenia implies to the count dropped below 150, 000. Platelets are one of the important components of blood and it is responsible for blood clotting and preventing blood loss.
Thrombocytopenia can result from reduced platelet production, excessive platelet destruction or splenic sequestration, which is often linked to a variety of health conditions, high risk medications or family history. The severity of the condition may vary from mild with very few or no signs and symptoms, to life threatening condition. Usually, it does not cause any problem until the count falls down significantly, leading to excess blood loss and may be internal bleeding. Causes Following are the probable causes or conditions that might be responsible for low blood platelet count. • Enlargement of the spleen (responsible for filtering unwanted material from the blood) causing deficiency of platelets. • Reduced platelet production caused due to: • Leukemia • Anemia (some forms) • Viral infections, e.g. AIDS, parvovirus, hepatitis C, chicken pox, etc.
Chemotherapy for cancer • Exposure to toxic chemicals • Excessive destruction of platelets and comparatively least production, this may be caused due to: • Being pregnant • Idiopathic thrombocytopenic purpura (ITP) • Thrombotic thrombocytopenic purpura (TTP), a condition causing multiple blood clots in the body • Rheumatoid arthritis • Lupus • Various bacterial infections • Hemolytic uremic syndrome • Adverse reaction of several high risk drugs and medications including some antibiotics, anti-malarial drugs like quinine and quinidine, and some anti epileptic drugs. • Consuming lots of alcohol • Miliary TB • Heart bypass surgery • Preeclampsia Complications: Drastic fall in blood platelet count (below 10, 000) may cause internal bleeding, rarely bleeding in the brain and intestines, making it life threatening. •
Symptoms Common symptoms developed as a consequence of Thrombocytopenia may include: • Excessive bruising on the skin • Rashes (caused due to superficial bleeding) • Excessive bleeding from injured part • Nose bleeding • Gum bleeding • Appearance of blood in stools or urine • Excessive bleeding during periods • Excessive bleeding while surgical procedures
When to see a doctor? If the above symptoms are worrying, you are experiencing an abnormally prolonged bleeding on normal cuts, don’t think twice to head for immediate medical attention. Diagnosis In most of the cases, Thrombocytopenia is diagnosed accidentally while performing routine blood tests or while testing for other conditions. In rest, diagnosis may involve work-up including physical exam, assessment of clinical history, blood tests and some other tests.
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Physical exam: Examine the body for rashes, enlarged spleen and other symptoms experienced that may indicate thrombocytopenia. Assessment of medical history: To look for a history of thrombocytopenia in the family. Blood test: To check for blood platelet count if dropped below normal range, which confirms the diagnosis of thrombocytopenia. Other tests: Based on the signs and symptoms, a variety of tests and procedures may be considered to find out the underlying cause. E.g. FBC with differential and blood film, bone marrow biopsy, etc.
Treatment In most of the cases, Thrombocytopenia is diagnosed accidentally while performing routine blood tests or while testing for other conditions. In rest, diagnosis may involve work-up including physical exam, assessment of clinical history, blood tests and some other tests. • Physical exam: Examine the body for rashes, enlarged spleen and other symptoms experienced that may indicate thrombocytopenia. • Assessment of medical history: To look for a history of thrombocytopenia in the family. • Blood test: To check for blood platelet count if dropped below normal range, which confirms the diagnosis of thrombocytopenia. • Other tests: Based on the signs and symptoms, a variety of tests and procedures may be considered to find out the underlying cause. E.g. FBC with differential and blood film, bone marrow biopsy, etc.