5 Factors That Influence Platelet Count
Platelets are the smallest of the 3 major type of blood cells. It is one of the main components in blood coagulation. They help stop bleeding by clumping at the blood vessel’s site of injury.
What is platelet count?
It is the quantity of platelets that circulate in the blood stream for every microliter of blood.
Laboratory values and platelet count units of measurement is in per cubic millimeter (a mm3 equals a microliter).
It can be either derived manually using a hemocytometer (manual platelet count) or through an automated platelet analyzer using electrical impedance (platelets automated count).
Average Platelet Levels
The spleen serves as a place of isolation for these cells. Normally, the spleen approximately allocates about 1/3 of platelets.
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Platelets can be evaluated through a sample of venous or capillary blood.
The capillary blood route is taken in times when taking the venous route is not recommended, or when it is difficult to do it due to superficial veins or veins that are sensitive.
Blood may also be taken from the fingertip, earlobe or toe in newborns.
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Factors That Influence Platelet Count
Understanding what is a platelet count is important and could be medically useful in many cases, like at times when a drop in amount happens.
Decreased blood platelet count is called thrombocytopenia. According to gradation, it can vary from moderate, moderately severe and severe. With a lower platelet count, the severity of the condition becomes higher.
This situation carries the risk for spontaneous bleeding in the skin and mucous membranes (nose, gastrointestinal and genitourinary tract).
The most dangerous bleeding areas are sites located in the central nervous system and the eye.
A low platelet count may be temporary and lasts for just a number of days, but may also be chronic, depending on the cause.
Condition usually improves when the disorder is established and treatment is provided to whatever disease or condition that underlies as the root cause of thrombocytopenia.
Sometimes these conditions need treatment with the use of drugs, surgery or blood transfusions.
I. The Decrease in Platelets
Can be innate or acquired (more often). Acquired forms are caused by the activity of factors that could have affected the bone marrow. These includes the following:
- Anemia – due to lack of folic acid (vitamin B9) or vitamin B12 causing reduction in the production of blood cells.
- Alcohol – thrombocytopenia is often observed in heavy drinkers, especially in those with poor healthy diet practices
- Viral infection;
- Toxic chemicals
- Ionizing radiation
- Tumor metastasis
- Intake of certain medications
Increased platelet degradation and consumption
In some cases of thrombocytopenia, platelets are decreased due to destruction or increased in their consumption. The normal functioning of bone marrow can not make up for the loss, which is why a fall in the number of platelets will develop.This abnormal condition can be divided into immune and non-immune. In non-immune thrombocytopenia, this group of abnormal condition includes hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP), and thrombocytopenia caused by disseminated intravascular coagulopathy. HUS is characterized by the triad consisting acute renal failure, hemolytic anemia and thrombocytopenia. This disease is characteristic of early childhood. The medical condition may display acute febrile symptoms with diarrhea, or upper respiratory tract infection. The most common cause that leads to the development of HUS is an infection with E.coli serotype O157: H7, although other bacterial and even viral pathogens can lead to this syndrome. TTP is a disease characterized by pentad of symptoms: thrombocytopenia, hemolytic anemia, renal failure, fever and neurologic disorders. The disease is caused by the reduced formation of enzyme ADAMTS13 important in the biology of von Willebrand factor, significant in coagulation. There will be increased production of clots in small blood vessels. The disease is usually caused by the formation of auto-antibodies against this enzyme which may be acute but a life-threatening condition.
Some other reasons for increased platelet degradation
- Certain drugs, alcohol, bacteria, viruses that directly decompose platelets.
- Immune system abnormal functioning, mistakenly identifying normal cells, forming antibodies to destroy them. The creation of antibodies may occur after transfusion of blood components or platelets, destruction is in part due to autoimmune diseases or certain medications taken.
- Due to the creation of numerous blood clots in the circulation, there can be increased platelet consumption. The causes may be due to severe bacterial or viral infection, a serious complication of pregnancy, drugs, or tissue damage.
- During pregnancy, platelet count may slightly be reduced.
Because of the “capture” of platelets in the spleen
The spleen plays an important role in the body’s defense against infection. However, it’s function in blood cell storage can be impaired to a number of reasons. The impairment can result to large amounts of platelet accumulation in the spleen. Normally, the platelets constitute a third of the blood cells stored in the spleen. But with enlarged spleen, it can reach up to 90% of platelets, which causes a relative decrease in its number in the blood stream. The life span of platelets remains normal. Commonly, thrombocytopenia due to splenomegaly doesn’t come with an increased risk for bleeding. But often, hypersplenism associated with liver cirrhosis, which is associated in disorders on normal coagulation, predisposes the patients to be at increased risk for bleeding.
II. Elevated platelet count:
Because of the coexistence of multiple causes.
Elevated platelet count can occur as a result of a disorder in the bone marrow, causing it to release large number of platelets in the circulating blood. It may also occur secondarily, as a result of the body’s response to organism in many diseases. If this disorder happens at the level of the bone marrow, it may lead to extremely large number of platelets, increasing the risk for thrombosis, which can be life threatening. Treatment may focus on the cause of the causative disease. Sometimes an increase in platelet counts is temporary, but in many cases it is chronic. Each may require specific therapy.
It is due to increased production of platelets as a response to certain diseases. In reactive thrombocytosis, the platelets still has the capacity to function normally. It can occur due to:
- Infection and inflammation
- Inflammatory diseases (rheumatoid arthritis, celiac disease, connective tissue disease, inflammatory bowel disease, and others.)
- Post menorrhagia
- After removal of the spleen
- Allergic reactions
- Kidney diseases
- Anemia due to iron deficiency
- Haemolytic anemia – anemia due to the decomposition of red blood cells
- Use of certain drugs, such as epinephrine, tretinoin, vincristine
- Post surgery
- After exercise, in response to increased physical activity
It is a consequence of a bone marrow impairment wherein it abnormally creates an extremely large number of platelets. The exact cause of the disease is unknown. Furthermore, in primary thrombocytopenia, platelets have a disturbed function. Due to the increased number of these cells, there will be an increased tendency for thrombosis. Also, it can be severely increased resulting to a tendency for bleeding disorders.
To conclude, the most common factors among many patients that have lead them to changes in platelet counts are existing disease/s, drugs and alcohol consumption.
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