What causes a low platelet count?
A normal platelet count is between 150,000 to 400,000 platelets per mcL of blood. A platelet count under 150,000 is considered low (thrombocytopenia).
Severe thrombocytopenia refers to a platelet count below 10,000. Internal bleeding can become life-threatening when your platelet count is at this level.
Low platelet counts may be caused by:
- Aplastic anemia (the body stops producing red blood cells)
- Immunological diseases
- Blood clotting abnormalities
- Bleeding disorders
- Hereditary conditions
- Bone marrow infection
- Enlarged spleen
- Certain medications, such as quinine, sulfa-containing antibiotics, heparin, and anticonvulsants
- Cancer, such as leukemia
- Cancer treatments including chemotherapy
What are the signs and symptoms of a low platelet count?
Low platelet counts or improperly functioning platelets can cause the following symptoms:
- Gum bleeding, nosebleeds, or persistent bleeding following a minor injury
- Blood in your urine, vomit, or stools
- Black, coffee-ground-looking stools
- Easy bruising
- Extreme tiredness
- Heavy menstrual periods
- Petechiae (tiny, flat, red spots under the skin caused by blood leaking from blood vessels)
- Purpura (caused by a minor blood vessel rupture beneath the skin that results in red, purple, or yellow-orange spots on the skin)
- Abnormally enlarged spleen or liver
- Weakness and confusion
What are different types of thrombocytopenia?
- Heparin-induced thrombocytopenia: This can develop after taking the drug heparin (a blood thinner used to treat blood clots). It requires medical treatment because it has the potential to become serious.
- Thrombotic thrombocytopenic purpura: This is a potentially fatal medical emergency related to a low platelet count. Small blood vessels can coagulate, and the blood supply to the kidneys or the central nervous system may be cut off. Depending on the organs involved, symptoms may include bruising or bleeding, fever, neurological issues, chest pain, abdominal pain, and jaundice.
- Thrombocytopenic purpura immune: This is more common in children, although it can also occur in adults after a viral infection, during pregnancy, or after contracting an immune system disease. It results in decreased platelet counts in healthy individuals, although the cause is unknown.
How is low platelet count diagnosed?
Your doctor may order the following tests to assess you for thrombocytopenia:
- Medical history: You will be asked about your family and medical history, current medications, and symptoms.
- Physical examination: Your doctor will look for bruises, rashes (petechiae), and an enlarged liver or spleen.
- Blood count: A complete blood count will be taken to assess your platelet, white blood cell, and red blood cell counts
- Blood clot test: This test measures the time it takes for blood to clot. These tests include the prothrombin and partial thromboplastin time.
If your platelet count is low, your doctor may order more tests to determine the cause:
What are the treatment options for low platelet counts?
Mild cases of thrombocytopenia may not require treatment, and the condition typically does not cause symptoms. The treatment approach depends on the underlying cause and the severity of thrombocytopenia.
Treatments may include:
- Transfusions of platelets or blood: Your doctor may transfuse packed red blood cells or platelets to replace lost blood if your platelet count becomes too low.
- Medications: Your doctor may recommend medications such as corticosteroids to increase your platelet count if your disease is linked to an immune system issue. Stronger drugs can be used to suppress the immune system if preliminary treatment does not work.
- Surgery: Your doctor may suggest surgically removing the spleen (splenectomy) if other therapies are unsuccessful.
- Plasma exchange: This may be necessary for a medical emergency caused by thrombotic thrombocytopenic purpura.
Can you prevent a low platelet count?
If you are at a higher risk of thrombocytopenia, the following measures may help prevent low platelet counts from occurring:
- Avoid medications that thin the blood and increase the risk of bleeding, including aspirin, Naprosyn, and ibuprofen
- Use caution when engaging in contact sports or other activities that could result in bruising or bleeding
- Reduce your exposure to harmful chemicals
- Use caution when shaving, brushing, and blowing your nose
- Limit alcohol consumption as it can damage the liver and reduce platelet synthesis
What Are Platelets and Why Are They Important? https://www.hopkinsmedicine.org/health/conditions-and-diseases/what-are-platelets-and-why-are-they-important
Platelet count. https://www.mountsinai.org/health-library/tests/platelet-count
Thrombocytopenia (low platelet count). https://www.mayoclinic.org/diseases-conditions/thrombocytopenia/symptoms-causes/syc-20378293
Thrombocytopenia and ITP. https://www.webmd.com/a-to-z-guides/thrombocytopenia-symptoms-causes-treatments
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plateletsPlatelets, also known as thrombocytes, are one of the components of blood, along with red blood cells, white blood cells, and plasma, the fluid component. Platelets collected from donors are administered as intravenous transfusions to treat thrombocytopenia, a condition with an abnormally low count of platelets. Common side effects of platelets include transfusion-transmitted infections and septic reactions, production of antibodies against donor platelets (alloimmunization), hemolytic transfusion reactions that destroy red blood cells, feverish (febrile) non-hemolytic reactions, transfusion related acute lung injury (TRALI), transfusion-associated graft-versus-host disease (TA-GVHD), transfusion-associated circulatory overload (TACO), and allergic reactions. Consult your doctor if pregnant or breastfeeding.
Thrombocytopenia (Low Platelet Count)
Thrombocytopenia (low platelet count) refers to a decreased number of platelets in the blood. Symptoms of thrombocytopenia include:
- Increased bruising
- Spontaneous bleeding
- Small, purple spots under the skin called purpura
There are many causes of thrombocytopenia such as decreased platelet production (viral infections for example rubella, mumps, chickenpox, hepatitis C, and HIV); increased platelet destruction or consumption (for example sulfonamide antibiotics, heparin, blood transfusions, and lupus); or increased splenic sequestration (enlarged spleen due to conditions, for example, liver disease, blood cancers, and more). Treatment of thrombocytopenia depends on the cause.
Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) and COVID-19Vaccine-induced immune thrombotic thrombocytopenia (VITT) is an extremely rare side effect of the COVID-19 vaccine and has only been seen with the Johnson & Johnson and AstraZeneca vaccines.
What Can Blood in the Stool Mean?Blood in the stool can be caused by a variety of health conditions. Find out more about what it can mean if you have blood in your stool.
whole bloodWhole blood is the entire blood collected from donors that contains all the blood components. Whole blood is primarily used for transfusion in adults with massive blood loss and active bleeding, who generally require all the blood components. Whole blood may also be reconstituted using stored plasma, red blood cells (RBCs), and platelets, usually used for cardiovascular surgeries and exchange transfusions in newborn babies. Common side effects of whole blood include hemolytic transfusion reactions, hives (urticaria), itching (pruritus), wheezing, shortness of breath (dyspnea), low blood pressure (hypotension), and serious allergic (anaphylactic) reactions.