Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Thrombocytopenia refers to platelet counts lower than the normal range of 150,000 to 400,000.
Causes of thrombocytopenia can be classified in 3 groups; diminished production, increased destruction, and splenic sequestration.
Treatment of thrombocytopenia may vary depending on the cause and the severity.
What is thrombocytopenia?
Thrombocytopenia is a lower than normal number of platelets in the blood.
Platelets are one of the cellular components of the blood along with white and red blood cells. Platelets play an important role in clotting and bleeding. Platelets are made in the bone marrow similar to other cells in the blood. Platelets originate from megakaryocytes which are large cells found in the bone marrow. The fragments of these megakaryocytes are platelets that are released into the blood stream. The circulating platelets make up about two third of the platelets that are released from the bone marrow. The other one third is typically stored (sequestered) in the spleen.
Platelets, in general, have a brief lifespan in the blood (7 to 10 days), after which they are removed from circulation. The number of platelets in the blood is referred to as the platelet count and is normally between 150,000 to 400,000 per micro liter (one millionth of a liter) of blood. Platelet counts less than 150,000 are termed thrombocytopenia.
A platelet count greater than 400,000 is called thrombocytosis.
Platelets iparticipate in coagulation. Platelets initiate a sequence of
reactions that eventually lead to the formation of a blood clot. They circulate in the blood vessels and become activated if there is any bleeding or injury in the body. Certain chemicals are released from the injured blood vessels or other structures that signal platelets to become activated and join the other components of the system to
initiate coagulation. When activated, the platelets become sticky and adhere to one another and to the blood vessel wall at the site of the injury to slow down and stop the bleeding by plugging up the damaged blood vessel or tissue (hemostasis).
It is important to note even though the platelet numbers are decreased
in thrombocytopenia, their function often remains completely intact. Other disorders exist that can cause impaired platelet function despite normal platelet count.
A low platelet count in severe cases may result in spontaneous bleeding or may cause delay in the normal process of clotting. In mild thrombocytopenia, there may be no adverse effects in the clotting or bleeding pathways.