Doctor's Notes on Thrombocytopenia (Low Platelet Count) In the Blood
Thrombocytopenia is condition where there is an abnormally low level of platelets in the bloodstream. Signs and symptoms of thrombocytopenia usually include some aspect of increased bleeding. For example, signs and symptoms include easy bleeding, easy bruising, pinpoint hemorrhages to the skin or elsewhere, nosebleeds, bleeding gums, heavy menstrual periods and blood in the urine or stool. Other signs and symptoms may include enlargement of the spleen, fatigue, anemia and/or jaundice.
There are three major causes of thrombocytopenia and are as follows: impaired production of platelets, increased destruction of platelets and sequestration of platelets in the spleen. These three major causes also have underlying causes – impaired production of platelets, for example, can be due to problems with the bone marrow (infections, aplastic anemia, medications, radiation, congenital disorders, for example,) where platelets are synthesized. Consumption or destruction of platelets can occur with certain medications (for example, sulfonamide antibiotics, quinine), transfusion reactions, rheumatologic conditions like systemic lupus erythematosus, immune destruction (for example, idiopathic thrombocytopenic purpura, heparin – induced thrombocytopenia) and other causes like vasculitis, sepsis, chemotherapy, hemolytic uremic syndrome or the HEELP syndrome in pregnant women. If the spleen enlarges for any reason (secondary to cirrhosis, for example), it can remove abnormal amounts of platelets from the blood.
Other causes can be related to dilution (IV transfusions of fluids) and some rare genetic conditions.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.