Thrombocytopenia

THROMBOCYTOPENIA purpura

Last Updated December 20th, 2021

What are Platelets?

Although we do not normally think of blood as a form of biological tissue, it is, in fact, a kind of connective tissue. It is composed of a variety of living cells carried in a liquid medium called plasma. Blood corpuscles are of several kinds and each kind has a specific function to perform. Red blood cells are responsible for delivering oxygen to organs and tissues throughout the body. White blood cells are responsible for maintaining immunity by fighting pathogens. Likewise, platelets too have a dedicated function.

Although medical science acknowledges that platelets may have multiple and diverse roles to play, the best-known function is that of enabling blood clotting when there is bleeding. Clotting not only prevents the loss of blood but also plugs wounds so that infectious agents and toxic substances are not able to enter the body by that route. Unlike most other cells, platelets lack nuclei. For this reason, some sources consider them not as true cells but as cell fragments.

 

What is Thrombocytopenia?

thrombocytesThrombocytopenia is a condition in which the number of platelets in the blood falls to an abnormally low level. As a result, blood is unable to clot at a normal rate in the event of bleeding and injury. Normally, when a blood vessel ruptures and begins to bleed, a series of processes are triggered in order to achieve coagulation of blood at that site. Platelets are not the sole factors involved in this ‘clotting cascade’; however, they play a central and critical role. When there is bleeding, platelets gather at the site and undergo a number of changes that allow them to clump together to form a physical ‘plug’ stemming further loss of blood. They change shape, secrete the contents of the granules contained within them and then aggregate, changing the state of blood from liquid to a coagulated gel in order to form a clot.

In a normal and healthy individual, the number of platelets lies between 150,000 and 450,000 per microliter of blood. When the platelet count drops below the lower limit of 150,000 per microliter, the person is considered to be suffering from thrombocytopenia.

 

What is the Reason for Thrombocytopenia?

Like other blood corpuscles, platelets too are formed in the bone marrow. They arise from bone marrow cells called megakaryocytes through a process called fragmentation. Their active circulating lifespan measures between a week and ten days following which they are disposed of by the spleen. There can be two main scenarios leading to a shortage of platelets in the blood; namely the insufficient production of platelets or the abnormally high destruction of platelets.

There may be a shortfall in the production of platelets, usually on account of bone marrow disorders. The bone marrow is the spongy tissue located within certain bones. This tissue is the site of production of blood cells including platelets. Thus, any disorder that affects the ability of the marrow to produce platelets can potentially lead to thrombocytopenia.

THROMBOCYTOPENIA purpuraOtherwise, certain conditions can lead to increased destruction of platelets. The spleen is the site of destruction of platelets. Afflictions of the spleen, particularly splenomegaly (enlargement of the spleen), can be responsible for a fall in the numbers of blood platelets. Other possible causative factors include certain drugs or immune dysfunction. Sometimes, there can be a combination of such factors leading to decreased platelet numbers. The list below includes both types of causes.

  • Enlargement of the spleen.
  • Kidney failure.
  • Liver cirrhosis, often as a result of alcohol abuse.
  • Pregnancy.
  • Blood transfusion.
  • Autoimmune disorder.
  • Myelodysplastic syndromes.
  • Defects in the structural tissue of bones as a result of diseases such as osteopetrosis and myelofibrosis.
  • Aplastic anemia.
  • Infectious diseases such as Lyme disease, malaria or dengue fever.
  • Cancers such as leukemia and lymphoma.
  • Bone marrow infections.
  • Certain viral infections such as HIV.
  • Nutritional deficiencies such as those pertaining to vitamin B12, folate, and iron.
  • Certain medications such as chemotherapy drugs, quinine, diuretics and anti-seizure medications.
  • Disseminated intravascular coagulation.
  • Genetic disorders such as Gaucher’s disease, May-Hegglin anomaly, and Bernard-Soulier syndrome.
  • Hemolytic uremic syndrome.

 

What are the Symptoms of Thrombocytopenia?

The signs of thrombocytopenia are as follows:

  • Increased frequency of nosebleeds.
  • Bleeding from the gums.
  • Frequent bruising.
  • Petechiae or small dark pinpricks beneath the skin as a result of ruptured blood capillaries.
  • Slow clotting.
  • Heavy menstrual periods.
  • Blood in the stools.
  • Fatigue.

Thrombocytopenia is not a disease or a disorder in itself. Instead, it is the sign of an underlying medical problem. Depending on the nature of the underlying condition, the indications of thrombocytopenia may be accompanied by a variety of other symptoms.

 

Are There Different Forms of Thrombocytopenia?

thrombocytopenia gum bleedingYes, medical science recognizes a few distinct types of thrombocytopenia and these are:

  • Immune Thrombocytopenic Purpura (ITP): This condition can affect both children and adults. In childhood, onset can occur following viral infection and the ITP even resolves itself eventually. However, adult onset ITP tends to persist in the long term. Scientists believe that ITP arises as a result of an erratic immune response that involves antibodies binding to platelets, marking them for destruction. This leads to a drop in platelet levels.
  • Thrombotic Thrombocytopenic Purpura (TTP): This is a rare disorder in which the blood has a heightened tendency to form clots which is responsible for the increased consumption of platelets. The reason for this is the deficiency of an enzyme responsible for the cleavage of a molecule known as the von Willebrand factor. This factor is a necessary component of the clotting process. As a result of this enzyme deficiency, platelets end up clumping together in small clot formations within the blood vessels. Therefore, platelets are unavailable when there is an actual injury or bleed. Onset of TTP may occur in childhood or adulthood and the disease is often hereditary. Onset in adulthood can be spontaneous but it may also be triggered by infections, pregnancy or even drugs.
  • Drug-Induced Thrombocytopenia (DTP): This is a relatively common condition. For instance, chemotherapy often causes bone marrow suppression leading to deficit of platelets in the blood. Alternatively, certain drugs or even their metabolites are capable of accelerating destruction of platelets by triggering an erratic immune response.

 

What Complications Can Thrombocytopenia Lead to?

Depending on the degree of deficit of blood platelets, thrombocytopenia may be classified as mild, moderate or severe. For diagnostic purposes, different sources define these limits differently. Moderate to severe thrombocytopenia can lead to the following critical outcomes:

  • Excessive loss of blood in the event of injury.
  • Significant loss of blood over a prolonged period of time leading to anaemia.
  • Spontaneous bleeding in the case of severe platelet deficit.
  • Internal haemorrhages which can be life-threatening.

 

What Tests Help To Diagnose It?

A simple blood test is sufficient to indicate a deficit of platelets. The possibility of pseudothrombocytopenia must first be ruled out. This false finding can occur as a result of errors during the collection of the blood sample. Therefore, repeating the blood test helps to secure confirmation of the results. Next, identification of the underlying cause is the main goal of diagnosis and this may involve the following tests:

  • Physical examination and medical history.
  • Blood tests including full blood count and peripheral smear.
  • Fecal occult blood test.
  • Imaging tests such as ultrasounds.
  • Bone marrow aspiration and biopsy.
  • Flow cytometry.

 

Treatment

  • In case the condition of thrombocytopenia is caused due to underlying causes such as an infection, the doctor will treat those conditions first.
  • In patients whose blood platelet levels have dropped below the normal range, a blood or platelet transfusion may be needed.
  • A surgical procedure to remove the spleen may be conducted.
  • In cases of severe thrombocytopenia, plasma exchange may be required.

 

Prevention

There are no sure shot prevention methods for this condition, there are certain risk factors that may help in reducing the symptoms.

  • Do not consume excessive amounts of alcohol; consuming alcohol can reduce the production of platelets.
  • Do not engage in any contact sports.
  • Do get treated for an infection as soon as you notice the symptoms.
  • Avoid blood thinning medications.

Facts

  • Thrombocytopenia can occur due to the use of certain drugs such as nonsteroidal anti-inflammatory drugs, penicillin etc.
  • Idiopathic thrombocytopenia is now known as immune thrombocytopenia.
  • ITP can be caused by rubella or German measles.

Facts

• This condition may develop after any kind of viral infection.
• One drop of blood contains 1,500,000-4,000,000 platelets.

Facts

  • Platelet transfusing can help in cases of severe blood loss and cancers.

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Dos and Don'ts

Dos
  • Get viral infections treated promptly and thoroughly, this helps in reducing the chances of developing thrombocytopenia and reducing the severity of the condition.
  • Get your blood count check regularly, in case you may need to get a transfusion.
  • Treat injuries such as cuts, bruises, nosebleeds etc. immediately, to prevent excess blood loss.
Don'ts
  • Indulge in contact sports, it could affect blood clotting, therefore making you bleed a lot.
  • Ignore doctor visits, as it is important to treat any medical condition in its early stages.
  • Forget to practice oral hygiene, to make sure that your gums do not bleed.

 

 

 

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Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
Tight phimosis ring
Phimosis Read to know everything about phimosis, types, symptoms, treatment, risks and prognosis for patients with this condition.
occupational hazards types
Occupational Hazards: How to vouch for your health at your workplace Occupational hazards affect millions worldwide. Chemical spills, faulty wires, deadly pathogen, and work-stress can happen anytime. Follow these…
glutamine workout
Glutamine: Why is this the right choice for muscle-gain supplement? Glutamine can help you gain muscles and build higher immunity. Read more to find out how you can…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
BRAT Diet: What is the right way to follow this diarrhea-relieving diet? BRAT diet, a simple diet consisting of just bananas, rice, applesauce, and toast, can help you combat the…
What is the right way to take a pregnancy test? A pregnancy test is undertaken to determine if you have conceived. A home pregnancy test is the most…
Gatorade: Top things you need to know about this staple energy drink Gatorade is a popular (in fact the most popular) energy drink worldwide. But this power-packed drinks comes with…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
liver cleanse detox
14 go-to foods that are best for a complete natural liver detox Liver cleanse can be achieved by just choosing or avoiding certain types of food. Liver itself is a detoxifying…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
Unbelievable health benefits of gooseberries (and a few tasty recipes) Gooseberries are antioxidant-rich tasty fruits that can be easily added in daily diet to improve overall health and…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
Valerian Root: The best way to achieve tranquil sleep every night Valerian root is probably one of the oldest and safest way to cure your insomnia. Find out how…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…