Low Platelet Count (Thrombocytopenia): Symptoms, Causes, Diagnosis, and Treatment

Low Platelet count is an alarming condition for both doctors as well as patients; in medical terms, it is referred to as Thrombocytopenia. Thrombocytes are your platelets, and penia means a decrease in number. So, it is a condition in which your platelet count decreases.

Let's understand - Thrombocytopenia. 

Have you noticed that bleeding from a wound stops after some time? The bleeding stops because of the platelets (blood cells). These platelets pile up together to form a blood clot.

What happens when there is a decrease in platelet cells?

The usual range of platelet count is 150,000 – 450,000 platelets per microliter of blood. If the platelet count reaches below 150,000/ microliter of blood, a severe condition develops known as Thrombocytopenia. 

Now, you must be wondering, what problem does it cause to the body? 

Some patients may not have any symptoms, but some may have severe bleeding, which could be life-threatening.

Let's look at some major signs and symptoms associated with Thrombocytopenia.

Symptoms Associated with Thrombocytopenia

If you have a low platelet count, you might observe the following symptoms during your everyday routine:

• You might notice small areas of bleeding into the skin that leads to tiny red spots.
• Sometimes, the blood also gets accumulated under the skin causes purple spots. There might be times when you have sudden and excessive nose bleeds.
• Bleeding from gums is also one of the common signs.
• Women might suffer from heavy menstrual bleeding.
• Sometimes, you may detect black or bloody stool.
• You might experience blood in your vomit.
• There are chances that you may encounter severe headaches, fatigue, muscular and joint pain.

If you feel any one or more of these symptoms, you should seek medical assistance.

Now, let us dive into some more details and take a clear idea of how this severe condition is caused. Sometimes the causes are unknown, but majorly, multiple factors are responsible for causing this particular bleeding disorder.

Causes of a Low Platelet Count

To understand causes, we need to know where these platelets are formed.

Platelets are formed in your bone marrow (spongy tissue present in your bone).

Now, if the platelet production by your bone marrow decreases or platelet destruction takes place at a higher rate, Thrombocytopenia develops.

Thrombocytopenia develops from 4 groups of causes:

1. Decrease in your platelet production:

This condition occurs due to the following reasons:

• If your bone marrow fails to produce platelets:

You may ask that how can the bone marrow fail to produce platelets? Well, it happens because of quinine, sulfonamides, anticancer drugs, Heparin, alcohol intake, etc. 

The other significant reasons can be-

• If you have leukemia (cancer of blood-forming tissues) and Lymphoma (cancer of the lymphatic system which fights infection).
• Vitamin B12 and folate deficiency.

2. Increased Destruction of Platelets:

It occurs due to autoimmune diseases (a condition where your body acts against your cells and destroys them).

3. Platelets trapped in the spleen:

Sometimes, the platelet gets entrapped in the spleen (an organ that fights infection). And it prevents your platelets from circulating in the bloodstream. Therefore, it causes a low platelet count in the blood.

4. Loss of Platelets:

Massive transfusion of old stored blood to bleeding patients may cause loss of platelets.

One of the major causes of Thrombocytopenia is drug-induced Thrombocytopenia. The most common drug used in patients undergoing surgeries is Heparin.

Heparin causing low platelet count is called Heparin-induced Thrombocytopenia.

Heparin-induced Thrombocytopenia is the most dangerous complication of heparin therapy. Still, thinking why?

Let me tell you!

Heparin-induced Thrombocytopenia (HIT):

Heparin is the standardized anticoagulant (a drug that prevents blood clotting) used in hospitalized patients.

It is observed that on the administration of Heparin, patients are prone to develop a blood clot. This occurs due to the formation of antibodies that initiate clot formation.

How is Thrombocytopenia Diagnosed?

When you visit a doctor, he will take a medical history to understand the extent and cause of the disease.

You will be inquired about the bleeding history, duration, history of medications, alcohol use, and recent history of blood transfusion.

You will also be asked about your family history regarding the same condition and recent exposure to Heparin.

After all the inquiries, your blood sample is taken for the following blood investigations:

1. To check, reduced platelet count usually ranges from 10,000-50,000/ microliter of blood.

2. Your blood film may show only occasional platelets, and that too enlarged.

3. With more advanced techniques, anti-platelet IgG antibodies can be detected on your platelet surface. These antibodies will attack your platelets leading to their low count.

4. The reduced life span of your platelets, sometimes less than an hour compared to the normal lifespan of 7-10 days.

Treatment of Thrombocytopenia:

Management of Thrombocytopenia is dependent on the underlying cause.

Treatment includes:

1. Steroids- Your doctor will prescribe you steroids to reduce platelet destruction and promote its production.

Drug of choice – Prednisolone 1-2mg/kg for three weeks or until the platelet count is normal.

2. Revalode 25mg (Eltrombopag) - It acts as a platelet growth factor. It will treat chronic immune-mediated thrombocytopenic purpura (ITP) in adults.

3. Platelet transfusion- During severe bleeding and life-threatening conditions, platelet transfusion is the temporary treatment done.

4. Splenectomy- Splenectomy is a removal of the spleen

Conclusion

If you discover any random conditions that advance your danger for Thrombocytopenia, it's crucial to avoid potential risk to ensure your wellbeing. A low platelet tally can put you in danger for undue draining and wounding.

It’s very important to consult your doctor if you find any signs and symptoms associated with Thrombocytopenia. You should seek immediate medical assistance in case of severe bleeding that cannot be controlled by the first aid methods. You can certainly do a lot to make some changes to your lifestyle by taking a nutritious diet.