When you get a small cut, the bleeding just stops after a while, right? Or have you ever noticed that sometimes you get blue or purple bruises on your body without hitting anything? The main reason behind these things is the little cells called ' platelets ' in our blood. But what happens when these helpers decrease in number? That is what we call Thrombocytopenia in medicine. Don't worry, let's talk about this simply.
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Simply put, what is Thrombocytopenia?
Thrombocytopenia is a condition where the number of platelets in your blood is lower than normal. Platelets are tiny , disc-shaped cells in our blood. Their main job is to form a clot at the site of a wound to stop bleeding. It's like patching a hole in a wall.
Have you ever wondered what this word means? “Thrombocytes” is another name for platelets. “Penia” means not having enough of something, a shortage. So when these two come together, “Thrombocytopenia” is formed.
Normally, a healthy person should have between 150,000 and 450,000 platelets per microliter of blood (a drop of blood contains about 35 microliters). If this number is less than 150,000 in your blood report, it is considered a condition called thrombocytopenia.
Do you have symptoms like these?
Most of the time, a small decrease in platelets doesn't cause any symptoms. However, if your platelet count drops significantly, you may experience these symptoms:
| Symptom | What happens in that? |
|---|---|
| Bleeding | Bleeding may occur from the gums or nose, especially when brushing your teeth. Women may have heavier or longer menstrual periods. Sometimes, blood may also be present in the urine or stool. |
| Bruises and spots | Blue/purple bruises (as if they were hit) appear on the body for no reason. These are called Purpura in medical terms. These are bleedings that occur under the skin. |
| Small red spots on the skin | Small red dots (spots) about the size of a pen tip can be seen on the skin, especially on the legs. These can also come in clusters. Doctors call these Petechiae . |
| Fatigue | Low platelet count alone does not cause fatigue. However, an underlying medical condition (e.g. anemia) that causes low platelet count may make you feel tired and fatigued. |
| Spleen enlargement | The spleen is an organ located on the upper left side of our abdomen. Sometimes, platelets can become trapped and destroyed inside it, which can cause a decrease in platelet count. Then the spleen becomes swollen. |
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Check Availability →Why do platelets decrease like this? What are the causes?
There can be many reasons why you might have low platelets. Very rarely, it can be hereditary. But most of the time, it's caused by another medical condition or a medication you're taking. Simply put, there are three main categories of causes.
1. Because the body does not produce enough platelets
Our bone marrow is the factory that makes these platelets. If the production of that factory is impaired, platelets will decrease.
- Cancerous conditions like leukemia
- Some types of anemia
- Viral infections , for example dengue, hepatitis C , or HIV
- Chemotherapy or radiation therapy for cancer
- Excessive drinking
- Ingestion of toxic substances such as pesticides and arsenic
2. Because platelets are destroyed faster than they are made
Even if the factory works well, if the hearth breaks down quickly, there will be a shortage of platelets.
- Pregnancy (for some)
- Autoimmune diseases. This is when our body's own immune system mistakenly destroys its own platelets. For example, lupus.
- Some bacterial or viral infections
- Some medications (e.g. Heparin)
- Rare conditions like Thrombotic thrombocytopenic purpura (TTP)
3. Because platelets get stuck in the spleen
Normally, about a third of our platelets are stored in the spleen. However, if the spleen becomes enlarged due to a disease such as cirrhosis of the liver, a large number of platelets become trapped inside it, reducing the number of platelets circulating in the blood.
There are also different types of thrombocytopenia.
Thrombocytopenia can be divided into several main types depending on the cause.
- Immune Thrombocytopenic Purpura (ITP): This is the most common type. What happens here is that our immune system destroys our own platelets due to a problem. This can come in two types: acute ITP in children and chronic ITP in adults.
- Thrombotic Thrombocytopenic Purpura (TTP): This is a rare but dangerous condition. Small blood clots form throughout the body. Because too many platelets are used to make these clots, the platelet count in the blood decreases.
- Drug-induced Thrombocytopenia (DIT): This condition can occur as a side effect of certain medications. It usually goes away when the medication is stopped.
- Gestational Thrombocytopenia: A condition that occurs during pregnancy, usually not serious. It often resolves after delivery.
How do you find this, Doctor?
It is often discovered incidentally during a routine blood test (Full Blood Count – FBC) done for another reason. Once your doctor finds out that you have low platelets, they will order a few more tests to find out the cause.
Remember, if your blood test shows low platelets, the most important thing is not to panic and see a doctor for advice.
| Test | What do you see in that? |
|---|---|
| Complete blood count (CBC/FBC) | The amount of red cells, white cells, and platelets in the blood is measured. |
| Blood Smear (Peripheral Smear) | The platelets are examined under a microscope to see if they have a normal shape and appearance. |
| Bone Marrow Test | If the cause is not clear, this test is done to see if the bone marrow factory is working properly. |
In addition, the doctor may examine your body and perform an abdominal ultrasound scan to check for an enlarged spleen or liver problem.
Could this situation be serious?
For most people, this is not a big problem. However, if the platelet count drops below 20,000, it can be dangerous. This is because bleeding can occur inside the body, especially in the brain, even without any injury. This is life-threatening.
Therefore, if you have Thrombocytopenia, it is very important to follow your doctor's instructions exactly and go to the clinics on time. If you experience symptoms such as severe headache, changes in vision, or difficulty speaking, you should immediately go to the Emergency Department (ETU) of the nearest hospital as these may be signs of a brain hemorrhage.
How is it treated?
Treatment depends on the cause of your low platelet count and how low your platelet count is.
- Treating the cause: If the cause of the low platelet count is a medication, the doctor will stop that medication and prescribe another medication. If it is an infection, they will treat it.
- Medications: If there is an immune system problem like ITP, the immune system is controlled by giving medications like steroids.
- Blood or platelet transfusion: If the platelet count is very low or there is severe bleeding, platelets are given externally (Platelet transfusion).
- Surgery: If other treatments fail to control the condition, a splenectomy may be necessary.
- Plasma Exchange: This treatment method is used in conditions like TTP.
How can you take care of yourself?
When living with this condition, it is important to reduce the risk of injury.
- Avoid dangerous activities: Stay away from contact sports like boxing, karate, and rugby.
- Be careful with medications: Always ask your doctor before using painkillers that increase the risk of bleeding, such as aspirin and ibuprofen.
- Limit alcohol: Alcohol can reduce the production of platelets in the bone marrow, so it is best to limit alcohol consumption.
💡 Take-Home Message
- Thrombocytopenia is a decrease in the number of platelets in the blood. This can increase the risk of bleeding.
- Most of the time, there are no symptoms. However, be aware of things like unexplained bruising, bleeding gums/nose, and red spots on the skin.
- There are many reasons for this condition. So, don't panic when you see low platelets in your blood report, but see a doctor to find out the cause.
- Treatment depends on the cause and severity of the condition. Sometimes no treatment is needed.
- Follow your doctor's instructions exactly. If you experience warning signs like severe headaches or vision changes, go to the hospital immediately.
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