Thrombocytopenia (low platelet count)

Thrombocytopenia is a condition in which you have a low blood platelet count.  Platelets (thrombocytes) are colourless blood cells that help blood clot.  Platelets stop bleeding by clumping and forming plugs in blood vessel injuries.

Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system problem.  Or it can be a side effect of taking certain medications. It affects both adults and children.

Thrombocytopenia may be mild and cause few signs or symptoms.  In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs.  Treatment options are available.

Thrombocytopenia signs and symptoms may include:

• Easy or excessive bruising
• Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots, usually in lower legs
• Prolonged bleeding from cuts
• Bleeding from your gums or nose
• Blood in urine or stools
• Unusually heavy menstrual flow
• Fatigue
• Enlarged Spleen
• Jaundice

Thrombocytopenia can be inherited or it may be caused by a number of medications or conditions.  Whatever the cause, circulating platelets are reduced by one or more of the following processes: trapping of platelets in the spleen, decreased platelet production or increased destruction of platelets.

Trapped Platelets
The spleen is a small organ about the size of your first located just below your rib cage on the left side of your abdomen.  Normally, your spleen works to fight infection and filter unwanted material from you blood.  An enlarged spleen - which can be caused by a number of disorders - may harbour too many platelets, causing a decrease in the number of platelets in circulation.

Decreased Production of Platelets
Platelets are produced in your bone marrow.  If production is low, you may develop thrombocytopenia.  Factors that can decrease platelet production include leukemia, some types of anemia, viral infections such as hepatitis C or HIV, Chemotherapy drugs, heavy alcohol consumption.

Increased Breakdown of Platelets
Some conditions can cause your body to use up or destroy platelets more rapidly that they're produced.  This leads to a shortage of platelets in the bloodstream.  Examples of such conditions include pregnancy, immune thrombocytopenia, bacteria in blood, thrombotic thrombocytopenic purpura, haemolytic uremic syndrome, medications.

Some people develop severe or long-term (chronic) thrombocytopenia.  Depending on what's causing your low platelet count, treatments may include:

Treating the underlying cause of thrombocytopenia.  If your doctor can identify a condition or a medication that's causing your thrombocytopenia, addressing that cause may clear up your thrombocytopenia.

For example, if you have heparin-induced thrombocytopenia, your doctor will direct you to stop using heparin and prescribe a different blood=thinning drug. 

Blood or platelet transfusions.  If your platelets level becomes too low, your doctor can replace lost blood with transfusions or packed red blood cells or platelets.

Medication. If your condition is related to an immune system problem, your doctor may prescribe drugs to boost your platelet count.  The first-choice drug may be a corticosteroid.  If that doesn't work, he may try stronger medications to suppress your immune system.

Surgery.  If other treatment options don't help, your doctor may recommend surgery to remove your spleen (splenectomy).