What is Thrombocytopenia
Thrombocytopenia is also known as thrombopenia and described as a blood disorder where there is a reduction in the number of platelets circulating in the blood stream. It is a condition that result from several factors such as medical disorders and drug intake.
Platelets are known to have a very critical role in blood coagulation and clotting, without it there will be an excessive loss of blood due to uncontrolled bleeding.
The amount of platelets in the blood is referred as platelet count and it normally ranges from 150,000 to 450,000 per one millionth of a liter of blood.
A platelet count less than 150,000 is referred to as thrombocytopenia while a platelet count greater than 450,000 is referred to as thrombocytosis.
1. Causes of thrombocytopenia
Thrombocytopenia can result from a variety of reasons. These reasons may be associated to factors like increased destruction or consumption of blood platelets, increased capturing of circulating platelets by the spleen, or decreased platelet production in the bone marrow.
An increase in the number of platelet destruction or consumption is evidently seen in a number of medical conditions. These conditions may either be related to immunity responses or not.
Certain medications may also result to developing low platelet count by causing reactions that work against blood platelets. This is referred to as drug-induced thrombocytopenia.
2. Testing and diagnosis of thrombocytopenia
Thrombocytopenia can be tested in two ways: through blood test and physical examination.
A Complete Blood Count (CBC) shows the number of blood cells circulating in the blood, including platelets. Normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood. In patients where the resulting complete blood count records fewer than 150,000 platelets, the individual is considered to have thrombocytopenia.
Physical examination of the individual may also sometimes be used to determine whether the individual developed thrombocytopenia. Assessments of medical history and signs of bleeding under the skin is performed to gather relevant information. Also, a feel of the abdomen can be useful to identify whether the spleen is enlarged.
3. Symptoms of thrombocytopenia
Patients with thrombocytopenia may display a number of signs and symptoms.
Easy or excessive bruising known as purpura, superficial bleeding, prolonged bleeding from cuts, bleeding from gums or nose, traces of blood in urine or stools, unusually heavy menstrual flows in women, and fatigue are all possible symptoms of thrombocytopenia.
The development of enlarged spleen and jaundice are some signs and symptoms of severe thrombocytopenia.
4. Effects of thrombocytopenia
Excessive bleeding may come together with thrombocytopenia and for that reason, it can lead to death. The disorder can result to dehydration of patients, leaving them vulnerable to other blood related disorders such as anemia and blood cancer.
Effects of the disorder depend on the underlying associated medical disorder and symptoms exhibited by the patient which may vary from one to another.
5. Complications related to thrombocytopenia
Thrombocytopenia can lead to serious health problems in patients. Dangerous internal bleeding can occur when the platelet count falls way below the acceptable minimum. In some patients, it can drop to as low as 10,000 platelets per microliter.
A huge drop may hardly occur with immediate medical intervention, but in case it happens, thrombocytopenia can result to bleeding in the brain of the patient; causing fatal conditions such as brain disorders.
6. Treatment of thrombocytopenia
Mild thrombocytopenia does not usually require treatment. Children can suffer from the type of thrombocytopenia, showing no signs and symptoms of the disorder. The condition later clears up on its own.
This is not always the case with grown ups. Adults can develop severe and long-term chronic thrombocytopenia that require medical treatment in solving the problem. There are several methods that can be used to treat thrombocytopenia. The type of treatment depends on the cause of the problem and the signs exhibited by the patient.
Treating the underlying cause of thrombocytopenia is always the first option. If the doctor can clearly identify any medication or condition that results to the drop in platelets, the best option of treatment will be addressing the cause to eventually clear up the condition.
Blood or platelet transfusions help greatly in situations where the platelet level is very low. The transfusion will involve the direct introduction of blood platelets into the bloodstream.
Sometimes, medication will be used to help treat the disorder. If the condition is immune system-related, the doctor may choose to prescribe drugs that are helpful in boosting platelet count. A good example of commonly used medication is corticosteroid but when it fails to work, stronger medications intended to suppress the immune system may be useful.
Surgery can come in handy when the above methods of treatment fail. Splenectomy is a surgery on the spleen, which is performed when the spleen is holding more platelets than what is should normally store.
In some cases, plasma exchange is needed, especially when thrombotic thrombocytopenic purpura results to a medical emergency where the only solution is plasma exchange.
7. Suggested lifestyle practices for people with thrombocytopenia
Individuals with thrombocytopenia have to guard against any injury due to the risk of blood loss. This can be achieved by avoiding activities that can be physically harmful like contact sports. Only engage in activities with minimum levels of risks.
Alcohol intake is known to slow the production of platelets in the body. For individuals who find it difficult not to drink, moderation must be exercised and a doctor’s advice should be sought before resorting to an amount of alcohol.
Since some medications can also lead to reduced platelet counts, the patient needs to be cautious with the use of over-the-counter medications. Common medications like aspirin and ibuprofen can impair platelet function and production.
8. Thrombocytopenia can be inherited
Not all patients that suffer from thrombocytopenia develop the disorder. In some cases, thrombocytopenia is inherited by the child from the parents, or the disorder may have come down a long family line.
Family medical records are important when the individual shows signs of excessive bleeding and jaundice, especially when frequent.
9. Anemia and cancer are diseases that relate to thrombocytopenia
Cancer of the blood deprives the body of sufficient blood as well as a reduction in the number of blood platelets. A cancer of the bone can also result in dysfunctional production of platelets in the bone marrow. Anemic people are also likely to suffer from thrombocytopenia.
Cancer and anemia are both known causes of thrombocytopenia.
- Van K. Morris, MD, Holly L. Spraker, MD, MS, Scott C. Howard, MD, MS, Russell E. Ware, MD, PhD, & Ulrike M. Reiss, MD (2010). Severe Thrombocytopenia with Iron Deficiency Anemia.
- Suresh Aravind, MD, MBA, Ying Wu, PhD, Gayatri Ranganathan, MS, & Luba Nalysnyk, MD, MPH (2008). Burden of Thrombocytopenia in Cancer Patients Undergoing Chemotherapy: a Retrospective Database Analysis.
10. Thrombocytopenia can be fatal
Knowing that thrombocytopenia involves the blood system, it can be fatal. The disorder can result to excessive loss of blood especially during an injury.
The lack of platelets, the blood component supposed to control bleeding by initiating normal clotting processes, leaves the body vulnerable to a huge drop in blood volume with excessive blood loss which can lead to shock. This can eventually lead to death when left without proper medical intervention.
Thrombocytopenia is a blood disorder that can be inherited from parents, or caused by an underlying medical condition. The reduction in platelets can be differentiated into three categories: trapping of platelets in an enlarged spleen, increased destruction of platelets as an effect of a disease or drug, or decreased platelet production in the bone marrow as a result of impaired functionality. Having understood what is thrombocytopenia, it should not be taken lightly.
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