Thrombocytopenia is any disorder where there is an abnormally low amount of platelets.
Platelets are one of three components of the blood, along with red blood cells and white blood cells. Platelets help the blood to clot.
Thrombocytopenia is sometimes associated with abnormal bleeding.
What causes thrombocytopenia?
There are two main causes of a low platelet count:
- Not enough platelets being made in the bone marrow
- Conditions that can cause too few platelets to be made include aplastic anaemia, cancers in the bone marrow, such as leukaemia, cirrhosis (scarring of the liver), folate or vitamin B12 deficiency and myelodysplastic syndrome (where the bone marrow does not make enough blood cells or makes defective cells).
The use of certain drugs may also lead to a low production of platelets in the bone marrow – the most common example here is chemotherapy treatment.
- Increased breakdown of platelets in the bloodstream or in the spleen/liver
- Increased breakdown of platelets either in the bloodstream or in the spleen/liver can be caused by disseminated intravascular coagulation (DIC), drug-induced thrombocytopenia (immune or non-immune types), hypersplenism (swollen spleen), immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura.
What are the symptoms of thrombocytopenia?
Symptoms of the condition include bleeding in the mouth and gums, easy bruising, nosebleeds and rash (pinpoint red spots called petechia).
Other symptoms usually depend on the cause; or there may not be any symptoms at all.
Most people with thrombocytopenia have no symptoms directly associated with low platelets. They may show symptoms related to underlying cause of thrombocytopenia, however.
In severe thrombocytopenia (platelet counts of less than 10,000 to 20,000), excess bleeding can occur if the person is cut or injured. Spontaneous bleeding can also happen when platelet numbers are severely diminished.
Spontaneous bleeding due to thrombocytopenia may be seen under the skin or in the oral cavity as tiny, pinpoint, non-tender, non-palpable, red flat spots due to tiny hemorrhages, called petechiae.
Purpura are small bruises or rashes, which are larger than petechiae, that can also be seen in severe thrombocytopenia.
What tests are needed?
A low platelet count can be picked up on a routine blood test. Blood tests include a full blood count (FBC) and blood clotting studies, such as the partial thromboplastin time (PTT) and prothrombin time (PT).
Other tests that may help diagnose this condition include bone marrow aspiration or biopsy.
How is thrombocytopenia treated?
The treatment and long-term outcomes of thrombocytopenia depends on the cause of the condition.
In some cases, a transfusion of platelets may be required to stop or prevent bleeding.
The main complication of thrombocytopenia is severe bleeding and this may occur in the brain or gastrointestinal tract.
Always contact your doctor if you experience unexplained bleeding or bruising.
When to Seek Medical Care
Thrombocytopenia is usually detected incidentally on routine blood work done for another purpose.
The doctor ordering the test can determine how severe the condition may be and how urgently further investigation needs to be done.
Thrombocytopenia is typically evaluated by internal medicine doctors (internists), family physicians, or blood disorder specialists (hematologists).