Thrombocytopenia is a decrease in the number of platelets in your blood. This most commonly diagnosed hemorrhagic diathesis can lead to anemia, and even to dangerous, because profuse and difficult to control, hemorrhages. What are the causes and symptoms of thrombocytopenia? How is thrombocytopenia treated?

Thrombocytopenia - what is it?

Thrombocytopenia( thrombocytopenia ) is a hemorrhagic disorder that results from a decrease in the number of platelets below normal, i.e. below 150-300 109 / l (150-300 thousand / mm³) .

Platelets (thrombocytes, PLT) are a type of blood cell produced in the bone marrow that play an important role in blood clotting. In the event of a blood vessel damage, thrombocytes join with each other and with the edges of the damaged vessel, thus inhibiting blood flow. If their amount is reduced, blood clotting does not take place properly, which increases the risk of haemorrhage and bleeding. Among them, the most dangerous are those for the central nervous system, as they can be fatal.

Thrombocytopenia - causes

Thrombocytopenia can be caused by:

  • inhibition of the production of platelets in the bone marrow due to:
    • drugs used to treat cancer
    • cancer of the blood and bone marrow: leukemia, myeloma, and also lymphoma
    • cancer of the immune system
    • bacterial and viral bone marrow infections, including AIDS
    • improper diet, poor especially in vitamin B12 and folic acid
    • spontaneous bone marrow decay;
  • platelet retention due to overly enlarged spleen

The spleen normally removes unnecessary elements from the blood. When it becomes enlarged, it retains more platelets than normal, causing them to drop in blood levels.

  • destroying platelets (when their loss is faster than marrow production) as a result of:
    • haemorrhages and bleeding
    • autoimmune diseases, including immune thrombocytopenia (aka essential thrombocytopenia, Werlhof's disease).

Its essence is a significant deficiency or even a complete lack of platelets in the blood.

The reason for this is:

  • action of antiplatelet antibodies (immunoglobulins)
  • bacterial diseases
  • vaccinations (especially jaundice vaccinations)
  • thrombotic thrombocytopenic purpura - a disease in which platelets tend to stick together to form dangerous aggregates (clusters)
  • hemolytic uremic syndrome
  • use of drugs, such as, among others :
    • containing acetylsalicylic acid,
    • diuretics,
    • anti-cancer drugs,
    • antiallergic drugs,
    • antiepileptic drugs,
    • medications for cardiac arrhythmias,
    • quinine (anti-malaria drug).

Thrombocytopenia - symptoms

  • tendency to bruise, often very large
  • minor bleeding under the skin that looks like a rash
  • heavy and / or long-lasting bleeding after injuries, procedures (e.g. dental)
  • frequent bleeding gums and nosebleeds
  • hematuria
  • presence of blood in the stool
  • very intense periods
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Thrombocytopenia in pregnancy

Reduction of platelet levels during pregnancy is a common phenomenon due to the activation of thrombocytes in the placental circulation and their shorter survival time. It is estimated that up to 5 percent. of women in the third trimester of pregnancy have thrombocytopenia.

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This condition is not a cause for concern if your platelet count is 100,000 or less. in 1 μl of blood. Otherwise, the pregnant woman may struggle with vitamin deficiencies or an infection, which is an indication for a doctor's appointment.

If a pregnant woman has a platelet count of 50,000 in 1 μl of blood, the assistance of a haematologist may be necessary. During childbirth, haemorrhage that is difficult to control may occur. In such a situation, the pregnant woman is given a special preparation containing platelets.

The threat to the life of both the fetus and the mother-to-be is the condition in which the number of thrombocytes drops to 20,000. in 1 μl of blood. Then, spontaneous internal hemorrhages may occur.

Thrombocytopenia - diagnosis

If thrombocytopenia is suspected, blood tests are performed to assess the level of thrombocytes. In some cases, a skin biopsy or bone marrow biopsy may be necessary.

Thrombocytopenia - treatment

Treatment of thrombocytopenia depends on the underlying cause. In the case of pregnant women or people with essential thrombocytopenia, the level of thrombocytesusually returns to normal on its own. If medications or other substances have decreased the level of platelets, they should be discontinued (in consultation with your doctor, of course). In the case of vitamin deficiencies, you should change your diet and / or take supplements.

When the level of thrombocytes is extremely low, a blood transfusion may be necessary, i.e. a transfusion of either whole blood or platelets.

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Pseudo-thrombocytopenia

If your blood tests show low levels of thrombocytes in your blood and you have no symptoms of thrombocytopenia, you may suspect pseudo-thrombocytopenia. This is a condition in which the actual number of platelets is normal and the decrease is a result of the thrombocytes sticking together in the test tube.

This process is the result of the action of unusual antibodies that stick to platelets, which are revealed only after a reaction with a substance in blood collection tubes.

The measuring apparatus counts only free plates, ignoring those stuck together - hence the false result. Then it is recommended to perform the test with the use of other reagents.

Category:

Cardiology