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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Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
PROGESTERONE_test
Progesterone test The progesterone test is a blood test used to determine the level of hormone progesterone in the blood…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
carrageenan seaweed
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…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
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…
Plexus Slim: Is this pink slimming drink the ultimate one-stop fat burner? How effective is Plexus Slim in helping people lose weight? What are its ingredients? Can it be safely…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
What to eat, what not to eat in the South Beach Diet? The South Beach Diet is one among the most popular weight loss programs that have been the talk…
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…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
antihepatitis core antigent
Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
50 common health conditions
What are the top 50 deadly and widespread diseases? A complete list of the top 50 most common and deadly diseases that plague humanity. Which disease is…