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Platelet count low effects


Low Platelet Count (Thrombocytopenia)

Blood is made up of several types of cells which float in a liquid called plasma. The types of blood cells are:

  • red blood cells
  • white blood cells
  • platelets (also called thrombocytes)

When your skin is injured or broken, your platelets clump together and form clots to stop the bleeding. When you don’t have enough platelets in your blood supply, your body can’t form clots.

A low platelet count is called thrombocytopenia. This condition can range from mild to severe, depending on its underlying cause. Some people with thrombocytopenia may not experience any symptoms; for more severe cases, uncontrollable bleeding can result in death.

Thrombocytopenia can be caused by a range of factors such as pregnancy, medical conditions such as leukemia, or certain medications (such as blood thinners). As a result, there are multiple treatment options for thrombocytopenia which may differ depending on the root cause of the condition.

Whether or not you experience symptoms of thrombocytopenia may depend on how low your platelet count is.

If you have a low platelet count, you may experience:

  • red, purple, or brown bruises, called purpura
  • a rash with small red or purple dots, called petechiae
  • nosebleeds
  • bleeding gums
  • bleeding from wounds that lasts for a prolonged period or doesn’t stop on its own
  • heavy menstrual bleeding

In more severe cases, you may bleed internally. Symptoms include:

  • blood in your stool
  • blood in your urine
  • bloody or very dark vomit

If you experience any signs of internal bleeding, seek immediate medical attention.

In rare cases, thrombocytopenia may lead to bleeding in your brain. Talk to a healthcare professional if you have a low platelet count and experience headaches or neurological problems.

There are many potential causes of low platelet count, including:

Bone marrow issues

Your bone marrow is the spongy tissue inside the bone where all the components of blood, including platelets, are produced. There are multiple reasons why a person’s bone marrow may not create enough platelets, such as:

  • aplastic anemia
  • certain vitamin deficiencies such as vitamin B12, folate, and iron
  • viral infections, including HIV, Epstein-Barr, mumps, rubella, and chickenpox
  • exposure to chemotherapy, radiation, or toxic chemicals
  • consuming too much alcohol
  • cirrhosis
  • certain types of cancers such as leukemia and lymphoma
  • myelodysplasia
  • Genetic conditions such as May-Hegglin and Wiskott-Aldrich syndromes

Platelet destruction

Platelets live about 7-10 days in people without thrombocytopenia. A low platelet count can be a result of the body destroying too many platelets too quickly. Some reasons a body might destroy its platelets include:

  • side effects of certain medications, including diuretics, some antibiotics, blood thinners, and anti-seizure medications
  • an enlarged spleen
  • autoimmune disorders such as immune thrombocytopenia (ITP), lupus, or rheumatoid arthritis
  • pregnancy, especially in the final weeks before delivery
  • a bacterial infection in the blood
  • rare serious conditions such as thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and disseminated intravascular coagulation
  • surgery. Platlets can be destroyed when passing through machines used for bypass surgery or blood transfusions, as well as human-made heart valves.

If you think you may be experiencing symptoms of low platelet count, talk to a healthcare professional — especially if you’re experiencing serious symptoms, such as wounds or cuts that won’t stop bleeding, or blood in your stools or urine.

It’s also important to be checked regularly if you are at risk of developing thrombocytopenia due to a medical condition, family history, or medication.

Physical examination

If your doctor suspects a low platelet count, they will first do a physical exam. Your doctor will check your body for unusual bruising or evidence of petechiae (small red and purple dots), which is a sign of capillary bleeding that often accompanies a low platelet count.

Your doctor may also feel your abdomen to check for an enlarged spleen or liver.

Medical history

Your doctor may also ask about the following:

  • if you have a family history of bleeding disorders
  • medications that you take
  • herbal supplements that you take
  • your eating patterns
  • alcohol intake and IV drug use
  • current sex protection methods

If you are diagnosed with low platelet count, this information can help your healthcare professional treat your condition effectively.

Tests

There are multiple blood, bone marrow, and ultrasound tests that can help your doctor diagnose this condition and determine the underlying cause.

Blood tests

To diagnose low platelet count, your doctor will need to do a complete blood count (CBC) test. This test is often performed with a simple blood draw in your arm.

A CBC test looks at the number of blood cells in your blood. It will tell your doctor if your platelet count is lower than it should be. A typical platelet count will range between 150,000 and 450,000 platelets per milliliter of blood.

Your doctor may also choose to perform a blood smear test, which looks at your blood under a microscope to see how the platelets look.

You blood may also be tested for platelet antibodies. These are proteins that destroy platelets. Platelet antibodies can be produced as a side effect of certain drugs, such as heparin, or for unknown reasons.

Blood-clotting tests, including partial thromboplastin time and prothrombin time, may also be ordered. These tests require a sample of your blood. Certain chemicals are added to the sample to determine how long it takes your blood to clot.

Ultrasound

If your doctor suspects that your spleen is enlarged, they may order an ultrasound. This test uses sound waves to make a picture of your spleen.

Bone marrow aspiration and biopsy

A bone marrow test may also be performed. There are two types of bone marrow tests: a biopsy and an aspiration. In some cases, both tests may be performed at the same time.

During a bone marrow aspiration, a small amount of bone marrow is removed from one of your bones.

In a bone marrow biopsy, a sample of your core bone marrow is removed, usually from the hipbone.

The treatment options for a low platelet count can vary. Your doctor or specialist will determine the appropriate treatment for low platelet counts based on the underlying cause and severity of your condition.

If the condition is mild, your doctor may choose to simply monitor you.

If your low platelet count is more severe, you may need medical treatment. Treatment options may include:

  • blood or platelet transfusions
  • changing medications that are causing a low platelet count
  • Prescribing steroids, immune globulin, or other medicines that suppress your immune system
  • spleen removal surgery

If you are at risk of developing a low platelet count, scheduling regular doctor’s visits will help you pay attention to potential signs and symptoms.

Let your doctor know about any supplements or medications you take. Also, be aware that certain over-the-counter pain medications like ibuprofen and aspirin can thin your blood.

When possible, avoid activities like contact sports that put you at risk for bleeding injuries, or talk to your doctor about safety measures.

If your spleen has been removed, watch for potential signs of infection — as the removal of the spleen can increase the risk — and seek medical attention if you start to feel ill or have a fever.

There are many reasons that your doctor may screen for low platelet count. In some cases, a routine blood test may indicate that your levels are low.

If you are at risk of developing a low platelet count due to an underlying condition or medical history, your healthcare professional may recommend that you take prevention measures. These may include:

  • avoiding activities with a high risk of bleeding or bruising (i.e., contact sports)
  • limiting alcohol consumption
  • making dietary changes
  • stopping or switching medications that affect platelets, including aspirin and ibuprofen
  • getting certain types of vaccinations
  • avoiding toxic chemicals

If left untreated, a low platelet count can be very serious because it can cause internal bleeding of the brain or the intestines.

In the worst cases, this may even cause death. That is why it is essential to seek medical care if you think you might be at risk.

While a low platelet count may sound scary, there is much that can be done to prevent and treat the condition. In some cases, the only recommended treatment is to simply monitor it.

However, some individuals with low platelet counts will require treatment. In most cases, the low platelet count is resolved by treating the underlying cause.

If you have a low platelet count or are at risk of developing one, your healthcare professional can work with you to create a prevention or treatment plan.

Low Platelet Count (Thrombocytopenia)

Blood is made up of several types of cells which float in a liquid called plasma. The types of blood cells are:

  • red blood cells
  • white blood cells
  • platelets (also called thrombocytes)

When your skin is injured or broken, your platelets clump together and form clots to stop the bleeding. When you don’t have enough platelets in your blood supply, your body can’t form clots.

A low platelet count is called thrombocytopenia. This condition can range from mild to severe, depending on its underlying cause. Some people with thrombocytopenia may not experience any symptoms; for more severe cases, uncontrollable bleeding can result in death.

Thrombocytopenia can be caused by a range of factors such as pregnancy, medical conditions such as leukemia, or certain medications (such as blood thinners). As a result, there are multiple treatment options for thrombocytopenia which may differ depending on the root cause of the condition.

Whether or not you experience symptoms of thrombocytopenia may depend on how low your platelet count is.

If you have a low platelet count, you may experience:

  • red, purple, or brown bruises, called purpura
  • a rash with small red or purple dots, called petechiae
  • nosebleeds
  • bleeding gums
  • bleeding from wounds that lasts for a prolonged period or doesn’t stop on its own
  • heavy menstrual bleeding

In more severe cases, you may bleed internally. Symptoms include:

  • blood in your stool
  • blood in your urine
  • bloody or very dark vomit

If you experience any signs of internal bleeding, seek immediate medical attention.

In rare cases, thrombocytopenia may lead to bleeding in your brain. Talk to a healthcare professional if you have a low platelet count and experience headaches or neurological problems.

There are many potential causes of low platelet count, including:

Bone marrow issues

Your bone marrow is the spongy tissue inside the bone where all the components of blood, including platelets, are produced. There are multiple reasons why a person’s bone marrow may not create enough platelets, such as:

  • aplastic anemia
  • certain vitamin deficiencies such as vitamin B12, folate, and iron
  • viral infections, including HIV, Epstein-Barr, mumps, rubella, and chickenpox
  • exposure to chemotherapy, radiation, or toxic chemicals
  • consuming too much alcohol
  • cirrhosis
  • certain types of cancers such as leukemia and lymphoma
  • myelodysplasia
  • Genetic conditions such as May-Hegglin and Wiskott-Aldrich syndromes

Platelet destruction

Platelets live about 7-10 days in people without thrombocytopenia. A low platelet count can be a result of the body destroying too many platelets too quickly. Some reasons a body might destroy its platelets include:

  • side effects of certain medications, including diuretics, some antibiotics, blood thinners, and anti-seizure medications
  • an enlarged spleen
  • autoimmune disorders such as immune thrombocytopenia (ITP), lupus, or rheumatoid arthritis
  • pregnancy, especially in the final weeks before delivery
  • a bacterial infection in the blood
  • rare serious conditions such as thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and disseminated intravascular coagulation
  • surgery. Platlets can be destroyed when passing through machines used for bypass surgery or blood transfusions, as well as human-made heart valves.

If you think you may be experiencing symptoms of low platelet count, talk to a healthcare professional — especially if you’re experiencing serious symptoms, such as wounds or cuts that won’t stop bleeding, or blood in your stools or urine.

It’s also important to be checked regularly if you are at risk of developing thrombocytopenia due to a medical condition, family history, or medication.

Physical examination

If your doctor suspects a low platelet count, they will first do a physical exam. Your doctor will check your body for unusual bruising or evidence of petechiae (small red and purple dots), which is a sign of capillary bleeding that often accompanies a low platelet count.

Your doctor may also feel your abdomen to check for an enlarged spleen or liver.

Medical history

Your doctor may also ask about the following:

  • if you have a family history of bleeding disorders
  • medications that you take
  • herbal supplements that you take
  • your eating patterns
  • alcohol intake and IV drug use
  • current sex protection methods

If you are diagnosed with low platelet count, this information can help your healthcare professional treat your condition effectively.

Tests

There are multiple blood, bone marrow, and ultrasound tests that can help your doctor diagnose this condition and determine the underlying cause.

Blood tests

To diagnose low platelet count, your doctor will need to do a complete blood count (CBC) test. This test is often performed with a simple blood draw in your arm.

A CBC test looks at the number of blood cells in your blood. It will tell your doctor if your platelet count is lower than it should be. A typical platelet count will range between 150,000 and 450,000 platelets per milliliter of blood.

Your doctor may also choose to perform a blood smear test, which looks at your blood under a microscope to see how the platelets look.

You blood may also be tested for platelet antibodies. These are proteins that destroy platelets. Platelet antibodies can be produced as a side effect of certain drugs, such as heparin, or for unknown reasons.

Blood-clotting tests, including partial thromboplastin time and prothrombin time, may also be ordered. These tests require a sample of your blood. Certain chemicals are added to the sample to determine how long it takes your blood to clot.

Ultrasound

If your doctor suspects that your spleen is enlarged, they may order an ultrasound. This test uses sound waves to make a picture of your spleen.

Bone marrow aspiration and biopsy

A bone marrow test may also be performed. There are two types of bone marrow tests: a biopsy and an aspiration. In some cases, both tests may be performed at the same time.

During a bone marrow aspiration, a small amount of bone marrow is removed from one of your bones.

In a bone marrow biopsy, a sample of your core bone marrow is removed, usually from the hipbone.

The treatment options for a low platelet count can vary. Your doctor or specialist will determine the appropriate treatment for low platelet counts based on the underlying cause and severity of your condition.

If the condition is mild, your doctor may choose to simply monitor you.

If your low platelet count is more severe, you may need medical treatment. Treatment options may include:

  • blood or platelet transfusions
  • changing medications that are causing a low platelet count
  • Prescribing steroids, immune globulin, or other medicines that suppress your immune system
  • spleen removal surgery

If you are at risk of developing a low platelet count, scheduling regular doctor’s visits will help you pay attention to potential signs and symptoms.

Let your doctor know about any supplements or medications you take. Also, be aware that certain over-the-counter pain medications like ibuprofen and aspirin can thin your blood.

When possible, avoid activities like contact sports that put you at risk for bleeding injuries, or talk to your doctor about safety measures.

If your spleen has been removed, watch for potential signs of infection — as the removal of the spleen can increase the risk — and seek medical attention if you start to feel ill or have a fever.

There are many reasons that your doctor may screen for low platelet count. In some cases, a routine blood test may indicate that your levels are low.

If you are at risk of developing a low platelet count due to an underlying condition or medical history, your healthcare professional may recommend that you take prevention measures. These may include:

  • avoiding activities with a high risk of bleeding or bruising (i.e., contact sports)
  • limiting alcohol consumption
  • making dietary changes
  • stopping or switching medications that affect platelets, including aspirin and ibuprofen
  • getting certain types of vaccinations
  • avoiding toxic chemicals

If left untreated, a low platelet count can be very serious because it can cause internal bleeding of the brain or the intestines.

In the worst cases, this may even cause death. That is why it is essential to seek medical care if you think you might be at risk.

While a low platelet count may sound scary, there is much that can be done to prevent and treat the condition. In some cases, the only recommended treatment is to simply monitor it.

However, some individuals with low platelet counts will require treatment. In most cases, the low platelet count is resolved by treating the underlying cause.

If you have a low platelet count or are at risk of developing one, your healthcare professional can work with you to create a prevention or treatment plan.

Why platelets are low and what to do

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Why low platelets are dangerous

Platelets are blood cells that can form clots, or blood clots. So they stop bleeding from cuts and other injuries. If there are not enough platelets, the body can no longer cope with “darning” the damage. This medical condition is called thrombocytopenia.

It is diagnosed when the number of platelets in the blood becomes below normal, that is, less than 150,000 per microliter, with a healthy rate of 150-400,000.

A low platelet count can be dangerous because bleeding becomes difficult to stop. Particularly serious consequences are caused by hemorrhages in the digestive tract or brain: they can lead to disability and even death.

However, much depends on the symptoms and how low the platelets have fallen.

Why platelets can be low

Sometimes thrombocytopenia is inherited, from parent to child. This is not a disease, but a feature of the body.

But more often, the number of platelets decreases for one of three reasons.

The body retains platelets in the spleen

This happens in people with an enlarged spleen. Normally, it filters unwanted substances from the blood. But when it fails, it can retain platelets in itself.

The body produces fewer platelets than it needs

Platelets, like other blood cells, are produced in the bone marrow. Its activity and health may be affected by:

  • leukemia and other types of cancer;
  • certain types of anemia;
  • persistent viral infections such as hepatitis C or HIV;
  • radiation and chemotherapy. These procedures are often prescribed in the treatment of cancer;
  • excessive alcohol consumption.

The body uses or destroys platelets faster than normal

It happens:

  • during pregnancy, and about 5% of expectant mothers right before the birth develop mild thrombocytopenia for unknown reasons;
  • for severe bacterial infections;
  • in autoimmune diseases such as systemic lupus erythematosus or rheumatoid arthritis;
  • with thrombotic thrombocytopenic purpura, when bruises suddenly form all over the body, which attract a large number of platelets;
  • in hemolytic uremic syndrome, this rare disease causes a sharp decrease in the number of platelets, destruction of red blood cells and impaired kidney function;
  • due to certain medications, including sulfa-containing antibiotics, anticonvulsants, and blood thinners (anticoagulants).

How to recognize a low platelet count

Sometimes it is discovered by accident, for example, during a complete blood test, which the therapist sends the patient as part of a preventive examination.

This incidental thrombocytopenia may not have symptoms. But more often, a lack of platelets makes itself felt by characteristic signs.

Thus, the first symptom is usually bleeding from the nose or from a cut, which cannot be stopped. Other common signs of low platelets include:

  • bleeding gums;
  • traces of blood in the stool (in this case it looks black, tarry), urine, vomit;
  • too long and heavy menstruation in women;
  • petechiae, small hemorrhages, which most often appear on the legs and look like a red or purple rash;
  • purpura, purplish bruises that come on easily and as if by themselves;
  • rectal bleeding.

What to do if platelets are low

Call a doctor. Self-medication in this case is unacceptable and can be deadly.

Call 911 urgently if bleeding cannot be controlled with normal first aid measures, such as applying a pressure bandage.

If you happen to know that your platelets are low, talk to the doctor who gave you a referral for a complete blood count. The doctor will conduct an examination and check if there are any threatening symptoms. Mild cases of thrombocytopenia do not require treatment.

But if there are symptoms or the doctor suspects a risk of internal bleeding, it will be necessary to establish the causes of the pathology. The doctor will study the medical history, ask about the lifestyle and medications taken, and refer to additional studies, such as ultrasound. And then, having calculated the cause, he will give recommendations or prescribe treatment. Which one depends on the diagnosis.

For example, if you are taking anticoagulants or anticonvulsants, the doctor will select a replacement drug without side effects. If anemia, hepatitis C, rheumatoid arthritis, or another disease is detected, you will be offered appropriate therapy. If an enlarged spleen is the cause of the low platelets, your doctor may recommend surgery to remove it.

In case of extreme thrombocytopenia, when the platelet count is below 10,000 per microlitre, a blood transfusion or purification (plasmapheresis) will be required. These procedures will need to be carried out urgently, because such a condition is deadly.

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Thrombocytopenia: Symptoms, diagnosis and treatment

Thrombocytopenia is a term for all conditions in which the number of platelets in the blood is reduced. A person can feel quite normal, however, such a condition with thrombocytopenia is dangerous, since internal bleeding of any organs can occur at any time, and the most dangerous thing is that a brain hemorrhage can occur.

Pathology occurs more often in women than in men. The frequency of detection in children is one case in 20 thousand.

Causes

Often the cause of the disease is an allergic reaction of the body to various medications, resulting in drug-induced thrombocytopenia . With such a malaise, the body produces antibodies directed against the drug. Drugs that affect the occurrence of blood failure of the bodies include sedatives, alkaloids and antibacterial agents.

Deficiency can also be caused by immune problems caused by the effects of blood transfusions. Especially often the disease manifests itself when there is a mismatch of blood groups.

The most commonly observed in humans is autoimmune thrombocytopenia . In this case, the immune system is unable to recognize its own platelets and rejects them from the body. As a result of rejection, antibodies are produced to remove foreign cells.

If the disease has a pronounced form of an isolated disease, then it is called idiopathic thrombocytopenia or Werlhof's disease . It is believed that such thrombocytopenia occurs against the background of a hereditary predisposition.

The manifestation of the disease is also characteristic in the presence of congenital immunodeficiency.

A lack of platelets in the body is observed in people with a reduced composition of vitamin B12 and folic acid. Excessive radioactive or radiation exposure for the appearance of insufficiency of blood cells is not excluded.

Symptoms

Usually, the first signal of a decrease in the level of platelets is the appearance of skin hemorrhages with minor trauma (impact, compression) of the soft tissues. Patients note the frequent occurrence of bruises, a specific punctate rash on the body and limbs, hemorrhages in the mucous membranes, increased bleeding of the gums, etc.

At the next stage, there is an increase in bleeding time with minor cuts, prolonged and heavy menstrual bleeding in women, the appearance of ecchymosis at the injection sites. Bleeding caused by trauma or medical manipulation (for example, tooth extraction) can last from several hours to several days.

With a significant decrease in the number of platelets, spontaneous bleeding occurs (nasal, uterine, pulmonary, renal, gastrointestinal), severe hemorrhagic syndrome after surgical interventions. Profuse intractable bleeding and cerebral hemorrhage can be fatal.

Diagnosis

First of all, if thrombocytopenia is suspected, it is necessary to do a complete blood count to determine the number of cellular elements and verify (confirm) the diagnosis of thrombocytopenia.

Many diseases that occur with thrombocytopenia have fairly pronounced symptoms, so differential diagnosis in such cases is not difficult. This applies, first of all, to severe oncological pathologies (leukemia, metastases of malignant tumors in the bone marrow, myeloma, etc.), systemic connective tissue diseases (systemic lupus erythematosus), liver cirrhosis, etc.

However, it is often necessary to conduct additional studies (bone marrow puncture, immunological tests, etc.).

Treatment

Mild thrombocytopenia does not bleed. Medical treatment is usually not required. Expectant management and determination of the cause of the decrease in platelets is recommended.

With moderate severity of the disease, hemorrhages in the mucous membrane of the mouth, increased bleeding of the gums, and increased nosebleeds are possible.


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