About Marked Thrombocytopenia

Overview

Blood consists of different types of cells with different functions. When activated, the blood cells known as thrombocytes, or platelets, stop internal bleeding by clumping together to plug leaks in blood vessels. Platelets are continuously produced, as they live for only seven to 10 days in circulation before the spleen destroys them. Thrombocytopenia refers to a low number of platelet cells in the blood.

Significance

A normal platelet count can be anywhere from 140,000 to 440,000 cells per microliter of blood, according to the Merck Manual. Marked thrombocytopenia refers to a platelet count so low that it could be medically significant. People with fewer than 50,000 platelets per microliter tend to bleed easily, even with minor injuries. When the count falls below 20,000 platelets per microliter, spontaneous bleeding can occur. Below about 5,000 platelets per microliter of blood, severe spontaneous bleeding is likely.

Symptoms

People with thrombocytopenia do not always show effects; according to the Merck Manual, some patients with counts less than 10,000 platelets per microliter live symptom-free for years. Common signs and symptoms of low platelet count include skin that bruises easily, prolonged bleeding from cuts, spontaneous bleeding from the gums or nose, heavy bleeding with dental work, and blood in urine or stools. Some people with thrombocytopenia have a characteristic pattern of pinpoint purple spots on the lower legs called petechiae that results from bleeding into the skin.

Causes

Thrombocytopenia can result when the body makes fewer platelets, sequesters the platelets in the spleen or destroys platelets too quickly. Bone marrow produces platelets, so any disease or chemical that compromises it—such as leukemia, viral infection or excessive alcohol consumption—can lower the platelet count. An enlarged spleen, a condition called speenomegaly, can trap too many platelets. Conditions that increase the destruction of platelets include autoimmune diseases, bacterial infections in the blood and thrombotic thrombocytopenic purpura—the formation of multiple small clots throughout the body—among others. Medications including heparin, quinine and anti-convulsants can increase platelet destruction.

Treatment

Mild cases of thrombocytopenia often do not require treatment. For more severe cases, treatment options depend on the cause. An enlarged spleen could be removed, or for autoimmune causes, immunosuppressing drugs could help. In cases of significant bleeding, the patient might need blood transfusions.

Lifestyle Precautions

Thrombocytopenia might make changes in lifestyle necessary. Because alcohol inhibits the production of platelets, doctors might discourage patients with thrombocytopenia from drinking. Likewise, a doctor might recommend against participation in high-risk activities or contact sports that could cause bleeding. People with thrombocyotpenia might want to avoid common medications such as aspirin and ibuprofen, which can cause bleeding in the stomach.

About this Author

In 20 years as a biologist, Susan T. McClure has contributed articles to scientific journals such as “Nature Genetics” and “American Journal of Physiology.” She earned her Ph.D. from the University of Maryland. She enjoys educating people about science and the challenge of making complex information accessible.