Thrombocytopenia

December 22 21:52 2019 Print This Article

Thrombocytopenia is any disorder in which there are not enough platelets. Platelets are cells in the blood that help blood to clot. These limits, however, are determined by the 2.5th lower and upper percentile, and a deviation does not necessarily imply any form of disease. The most serious risk of bleeding, however, generally does not occur until the platelet count falls below 10,000 to 20,000 platelets per microliter. Immune thrombocytopenia (ITP) is a commonest blood disorder that causes thrombocytopenia or low platelet count.

In addition, thrombocytopenia may occur as a reaction to a medication. It happens when platelets are lost from the circulation faster than they can be replaced from the bone marrow where they are made.This is particularly the case during pregnancy, when bleeding problems, particularly during first and third trimester, as well as during and after delivery, often occur. Apart from ITP, many drugs can cause thrombocytopenia. Anyone with fewer platelets has some degree of thrombocytopenia.

Thrombocytopenia often occurs as a result of a separate disease or disorder. This condition is sometimes associated with abnormal bleeding. The number of platelets in a blood sample also decreases rather quickly with time and a low platelet count may be caused by a delay between sampling and analysis. The secondary hemostatic phase begins when the coagulation pathway is activated on the surface of the activated platelets to form a fibrin meshwork, which serves to reinforce the platelet plug.

Decreased platelet counts can either be due to reduced production in the bone marrow, or increased consumption in the circulation or abnormal distribution (pooling) within the body. The average life span of a platelet in the blood is 10 days. Thrombocytopenia often improves by treating the underlying cause. If bleeding is severe, you may need a blood transfusion. Historically, thrombocytopenia has been a cause for unnecessary, often invasive, additional testing, as well as cesarean deliveries.

Causes of Thrombocytopenia

The comman causes of Thrombocytopenia include the following:

  • Thrombocytopenia can occur when the bone marrow does not produce enough platelets, as happens in leukemia and some anemias.
  • Pregnancy, which may cause mild thrombocytopenia.
  • Sometimes, certain medications can cause a thrombocytopenic reaction by confusing the immune system and causing it to destroy platelets. Examples include heparin, quinine, some oral diabetes drugs.
  • Idiopathic thrombocytopenic purpura (ITP), a condition in which your immune system mistakenly identifies platelets as a threat and forms antibodies that attack them.
  • Thrombocytopenia may occur because of a build up of platelets outside the normal bloodstream. This can occur in a patient with a very large spleen.
  • Blood poisoning (septicemia) from severe bacterial infections, which may lead to destruction of platelets.

Symptoms of Thrombocytopenia

Some sign and symptoms related to Thrombocytopenia include the following:

  • Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs.
  • Bruising.
  • Unusually heavy menstrual flows.
  • Bleeding in the skin may be the first sign of a low platelet count.
  • Blood in urine or stools.
  • A rash that looks like pinpoint red spots.
  • Profuse bleeding during surgery.
  • Mild thrombocytopenia can occur without symptoms.

Treatment of Thrombocytopenia

Here is list of the methods for treating Thrombocytopenia:

  • People who have a very low platelet count are often treated in a hospital or advised to stay in bed to avoid accidental injury.
  • If an infection is suspected, treatment of it with antibiotics could be started.
  • For some infections, especially viral ones such as glandular fever, there is no specific treatment and close observation may be necessary.
  • Fetal blood sampling with maternal intravenous immunoglobulin (IVIG) treatment if the fetus is thrombocytopenic.
  • In some cases, a transfusion of platelets may be required to stop or prevent bleeding.
  • Surgery: Sometimes, removing the spleen (splenectomy) relieves signs and symptoms or helps improve chronic idiopathic thrombocytopenic purpura that doesn’t respond to corticosteroids.
  • Patients with thrombotic thrombocytopenic purpura (TTP) will probably require large-volume plasmapheresis (plasma exchange).