Thrombocytopenia (Low Platelet Count) - Treatment

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What is the treatment for thrombocytopenia (low platelet count)?

The treatment of thrombocytopenia is largely dependent upon the cause and the severity of the condition.

Some situations may require specific or emergent treatments, whereas, others need only be managed by occasional blood draws and monitoring of the platelet levels.

In auto-immune thrombocytopenia or ITP, steroids can be used to suppress the immune system in order to impair the destruction of platelets. In more severe cases, intravenous immunoglobulins (IVIG) or monoclonal antibodies may also be given to alter the immune process. In refractory cases, splenectomy (removal of the spleen) may be necessary.

If a drug is thought to be the cause of low platelet count, then it may be discontinued by the supervising physician. In patients with HIT, it is very important to remove and limit the future use of any heparin products, including low molecular weight heparin (like Lovenox), immediately to prevent further immune response against the platelets.

If TTP or HUS is diagnosed, the treatment may include plasma exchange, plasmapheresis, or eculizumab. In cases with severe kidney failure, dialysis may be necessary.

In general, platelet transfusion is not necessary, unless an individual with low platelets (less than 50,000) has an active bleeding or hemorrhage, or needs a surgery or other invasive procedures. Frequently, a platelet transfusion may be recommended without any bleeding if the count is less than 10,000.

In suspected cases of HIT or TTP, transfusion of platelets may not be recommended because the new platelets could potentially make the condition worse and more prolonged.

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Comment from: Just Nancy, 55-64 Female (Patient) Published: January 30

I have had Chronic ITP (immune thrombocytopenic purpura) for 20 years. I got it when I was in my late 40s. I have been through all the treatments, transfusions, IVIG (intravenous immunoglobulin), prednisone, I am now on Promacta 75 Mg. It seems to be working well, I have not had to have any infusions since I have been on it, about a year now. My normal platelet count with Promacta usually stays in the range of 65000 to 100000. The lowest they got was 2000 before I was on the Promacta. My platelet count has always dropped when I get a virus (cold, flu, etc.). Now they only go down to about 36000. No other treatment needed unless they drop to below 10000

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Comment from: peg, 75 or over Female (Patient) Published: October 03

I have a 4.2 white blood count and the platelets 138. Diagnosis is thrombocytopenia. I have just some bruising. Surgery on esophagus was in 2013. I'm taking Evista and Synthroid. They cannot figure the cause, so I'm going to a hematologist. I have a very small liver cyst, for a number of years. I will revisit the doctor in one year.

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