Thrombocytopenia is a condition of lower than normal platelet count in the blood. Platelets are blood cell fragments formed in the bone marrow along with other types of blood cells. A normal platelet count is essential, as platelets are helpful in the clotting of blood. Platelets travel through the bloodstream and collect at any site where blood vessels are damaged. This causes clotting of blood, which prevents loss of blood through excessive bleeding. However, a low platelet count can lead to continued bleeding, which is a major risk.
In adults, the normal platelet count is 150,000 to 450,000 per microliter of blood. A platelet count lower than 150,000 is considered abnormal. This condition of a low platelet count is termed thrombocytopenia. In case the platelet count falls below 50,000 per microliter of blood, mild bleeding can occur. When the platelet count is in the range of only 10,000 to 20,000, it increases the risk of serious bleeding. Immune thrombocytopenic purpura can affect adults as well as children. For instance, after viral infection, children often show symptoms of idiopathic thrombocytopenic purpura. However, children usually recover from even acute ITP within six weeks without needing specific treatment.
Symptoms of Thrombocytopenia
Patients affected by severe thrombocytopenia may show symptoms of abnormal bleeding.
- Symptoms include blood in the stool or urine and/or excessive bleeding from the mouth or nose. Reddish spots on the skin may be associated symptoms. These symptoms most often appear on the lower legs.
- Symptoms of thrombocytopenia may include bleeding inside the gastrointestinal tract.
- Excessive or frequent bruising or abnormal vaginal bleeding may also among symptoms.
- Symptoms of excessive bleeding may be present after surgery or dental work.
- Neurological symptoms and headaches may also be present in people suffering from a low platelet count.
Treatment of Thrombocytopenia
Treatment of thrombocytopenia varies based on the cause and severity of the condition. Severe situations may require emergency treatment while other conditions can be managed using treatments such as occasional blood tests and monitoring of the platelet levels.
- Steroids: For the treatment of autoimmune thrombocytopenia, steroids can suppress the immune system to impair excessive destruction of platelets.
- Intravenous immunoglobulin: Treatment of severe cases of thrombocytopenia is possible using intravenous immunoglobulin for altering the immune process.
- Splenectomy: Splenectomy involves the removal of the spleen. This treatment may be necessary in refractory cases.
- Dialysis: Treatment of severe cases involving kidney failure may require dialysis. If thrombotic or hemolytic uremic syndrome is diagnosed, treatment such as plasma exchange, eculizumab, or plasmapheresis may be included.
- Platelet transfusion: Treatment using platelet transfusion is generally not required. Even in cases when the patients have platelet counts of less than 50,000 and have hemorrhage or active bleeding or need surgery or other invasive procedures, platelet transfusion treatment is not required. However, in cases that do not necessarily involve bleeding but where platelet count less than 10,000, a platelet transfusion may be recommended.
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