Thrombocytopenia
Thrombocytopenia is a condition in which the blood has low levels of platelets. Platelets, also known as thrombocytes, are colorless blood cells that help in blood clotting. They clump together to prevent blood loss through tiny holes in the blood vessels. Thrombocytopenia most frequently occurs as a result of another medical condition, a side effect of medication or chemotherapy.
Causes of Thrombocytopenia
There are many causes of thrombocytopenia. The low platelet count in the blood may result from reduced production of platelets, trapped platelets, or the breakdown of platelets once they are produced.
Reduced Production of Platelets
Platelets are produced in the bone marrow, so diseases of the bone marrow, such as leukemia or certain types of anemia, such as aplastic anemia, can lead to a reduction in the number of platelets the body produces. Platelet production may also be reduced by viral infections, such as HIV, cirrhosis of the liver, chemotherapy treatments, exposure to toxic chemicals or heavy alcohol consumption. Some people develop thrombocytopenia from a deficiency of vitamin B12.
Trapped Platelets
The spleen, an abdominal organ just below the ribcage, works as a filter and a storage location for blood cells. When the spleen becomes enlarged, a disorder known as splenomegaly, it may trap and store too many platelets, resulting in a decrease in the number of platelets circulating through the bloodstream.
Breakdown of Platelets
Several conditions may result in the breakdown of platelets cells. Some of these include: pregnancy, blood poisoning, autoimmune disorders and bacteria in the blood. A rare condition known as TTP, which causes excessive clotting, and hemolytic uremic syndrome, which impairs kidney function, may contribute to platelet breakdown. Some medications, including heparin, quinine and interferon may also cause the breakdown of platelets.
Thrombocytopenia often improves when its underlying cause is treated.
Symptoms of Thrombocytopenia
The many symptoms of thrombocytopenia are all related to the abnormally low number of platelets in the blood. They may include the following:
- Extreme malaise
- Excessive bleeding from injury
- Excessive bruising
- Excessive bleeding after surgery or dental procedures
- Spontaneous bleeding, often of the gums or nose
- Blood in the urine or stool
- Unusually heavy menstrual bleeding
Pinpoint reddish spots (petechiae) which usually appear on the lower legs, are also symptoms of thrombocytopenia.
Diagnosis of Thrombocytopenia
To diagnose thrombocytopenia, a physical examination and a review of symptoms is performed. The patient will undergo a thorough physical examination to check for an enlarged spleen, any unusual bruising or red spots, any signs of infection, such as a fever. If thrombocytopenia is suspected, the following diagnostic tests are performed:
- Complete blood count
- Blood smear
- Bone marrow tests
- Blood clotting tests
An ultrasound scan of the spleen may also be performed.
Treatment of Thrombocytopenia
Mild forms of thrombocytopenia may not have to be treated at all and may resolve on their own. Forms of thrombocytopenia caused by medication may be treated by simply stopping the medication in question. Other treatments of thrombocytopenia depend on the severity of the condition and may include:
- Medications, especially corticosteroids
- Blood or platelet transfusions
- Immunosuppressant drugs
- Splenectomy,removal of the spleen
For many patients, thrombocytopenia is a temporary condition from which they recover. For some patients, however, it remains a chronic condition.
Complications of Thrombocytopenia
A serious complication of thrombocytopenia is the danger of excessive uncontrolled bleeding. Patients with chronic thrombocytopenia should avoid contact sports and other activities which might likely cause injury. Patients with thrombocytopenia should also avoid taking blood-thinning medications and avoid exposure to infection as much as possible. Living within these restrictions, patients with thrombocytopenia should be able to live full and enjoyable lives.