Thrombocytopenia (Low Platelet Count)

  • Medical Author:
    Siamak N. Nabili, MD, MPH

    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    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.

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What are the symptoms of thrombocytopenia?

In many instances, thrombocytopenia may have no symptoms, especially if mild, and it can be detected only incidentally on routine blood work done for other reasons.

If thrombocytopenia is severe, for example less than 20 per micro liter, it can potentially manifest as increased bruising or bleeding when a person is cut or injured, or increased bleeding during menstrual period.

Spontaneous bleeding can also happen with severe thrombocytopenia (less than 10,000 to 20,000 platelets). This type of bleeding usually occurs under the skin or the mucus membrane (the inner lining of the oral cavity, gastrointestinal tract, or the nasal cavity).

Petechiae may be seen in patients with very low platelet counts. Petechiae are small (pin head size) red, flat spots seen under the skin on the dependent parts of the body because of increased pressure due to gravity, for example, on the lower legs. These happen because of bleeding out of the tiny blood vessels under the skin or the mucus membrane. Petechiae are generally not palpable or painful.

Other rashes or bruises seen in thrombocytopenia are called purpura, which are small, purple spots under the skin as a result of hemorrhage. These are typically greater than 3 millimeters in diameter and may represent a confluence of petechiae.

When should I seek medical care for thrombocytopenia?

If thrombocytopenia is detected on a routine blood work, it is generally addressed and investigated by the physician who orders the test. In people with known thrombocytopenia, follow-up care is decided based on the diagnosis and the severity.

People with thrombocytopenia are, in general, initially cared for by an internist or a family practice physician. Sometimes, consultation with a doctor who specializes in blood disorders (hematologist) is helpful for more thorough investigation or treatment.

Medically Reviewed by a Doctor on 4/30/2015
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