Thrombocytopenia represents a decrease in the number of blood cells called blood platelets, which may cause bleeding in the skin and internal organs. This is a lack of blood platelets, small blood cells that play a key role in the closure of damaged blood vessels may cause excessive bleeding. Normal blood platelet count in blood is 150 – 450 x 109/L.
Signs and symptoms
An enlarged spleen that can be determined by clinical examination – palpation or ultrasound is one of the possible signs and symptoms. Detection of an enlarged liver can also point out to possible chronic liver disease, which may be another cause of thrombocytopenia.
Skin bleeding appears most often in the form of small red spots that do not vanish after exposed to pressure – petechiae when the platelet count gets significantly reduced. They are most often located in the area of the ankles and feet. Furthermore, bleeding in the gums and in the oral cavity may occur.
The skin bleeding, larger of petechiae. called purpura, or ecchymosis, a skin bleeding similar to a hematoma, which is most often located on the feet, but also in other parts of the body may occur. Ultimately, stool bleeding, urinary tract infections or prolonged menstrual bleeding can lead to a significantly lower number of platelets.
Thrombocytopenia may be hereditary or caused by various different reasons. Some of the important ones include:
Decreased production of platelets – Thrombocytopenia due to decreased production of platelets is most commonly occurring with the decreased production of other blood cells, such as in leukemia or myelodysplastic syndrome. Another possible cause may be the absence of vitamin B12 or folic acid, viral and bacterial infections, sepsis, and liver failure.
Increased breakdown of platelets – A number of various conditions such as pregnancy, hemolytic uremic syndrome, autoimmune diseases, certain medications, thrombotic thrombocytopenic purpura may cause an increased breakdown of platelets, so when platelets are getting destroyed faster than they are produced that results in reduced blood platelet count.
Platelets trapped in the spleen – A disorder of redistribution of platelets in circulation occurs when the spleen is enlarged. Normally, there are about 30% platelets in the spleen and an enlarged spleen stores up to 90%, while there are few in the circulation. The platelet life is normal and there is no increased risk of bleeding. If the enlarged spleen is associated with liver cirrhosis, blood coagulation is disturbed and there is a risk of bleeding.
Thrombocytopenia treatment depends on the cause and severity of the condition. The main goal of the treatment is to achieve a sufficient number of platelets, preventing serious bleeding.
Mild thrombocytopenia sometimes does not need to be treated because bleeding can stop normally. In severe thrombocytopenia, on the other hand, the doctor will prescribe medication to you or change the drugs you are currently taking to stop their side effects.
Treatment of the underlying cause of thrombocytopenia when your doctor identifies a condition that is causing thrombocytopenia will improve the signs and symptoms.
Drugs and therapeutic procedures used to stabilize serious conditions caused by thrombocytopenia may include blood or platelet transfusion, splenectomy (surgical removal of the spleen), plasma exchange, or use of corticosteroids or immunoglobulins, which block the effects of the immune system.