Thrombocytopenia

What is Thrombocytopenia?

Normal platelet counts range from 150,000-450,000 platelet per microliter of circulating blood. There is constant renewal of platelets from production by bone marrow. Thrombocytopenia occurs where there are decreased numbers of platelets in the blood.

What are clinical manifestations of Thrombocytopenia ?

Platelets are a component of our blood which helps blood to clot and stop bleeding. Thus when platelet counts are low, bleeding problems may occur. The symptoms vary from person to person and also depending on severity of thrombocytopenia (ie how low the platelet counts are). Common symptoms include spontaneous bruising, bleeding gums, nose bleeds or petechiae (tiny red/purple dots on the skin).

Sometimes, patients may be asymptomatic with no bleeding manifestations, and this was detected in the course of routine blood count.

What are causes of Thrombocytopenia ?

There are multiple conditions which can cause thrombocytopenia. These include conditions such as:

  • Viral Infection
  • Drug-induced
  • Vitamin B12 or folate deficiency
  • Liver disease with hypersplenism
  • Myelodysplastic Syndrome (MDS)
  • Autoimmune diseases eg Primary Immune thrombocytopenia (ITP), systemic lupus erythematosus (SLE)

How Should We Evaluate Patients with Thrombocytopenia?

A thorough evaluation of your medical history, any bleeding symptoms and physical exam by your doctor will be helpful.

In addition tests to evaluate blood counts, clotting studies, screen for autoimmune conditions may be considered.

Sometimes, bone marrow aspiration and biopsy may be needed to evaluate further.

Management of Thrombocytopenia

This depends on understanding of the underlying cause. In addition, the severity of thrombocytopenia and also presence of bleeding symptoms would be important factors to consider.

If the cause of thrombocytopenia is unclear after retesting and initial evaluation, or if thrombocytopenia is severe (particularly in association with bleeding symptoms), consultation with haematologist should be considered.