If you’ve recently received the results of your complete blood count (CDC) or been told by your doctor that you have a lower platelet count, you’re probably wondering what this means.
A low platelet counts is a disorder of the blood with many possible causes.
A low platelet count is also referred to as thrombocytopenia, which is not always something serious to be concerned about. However, the bleeding caused by thrombocytopenia can be something to watch out for in serious cases.
The treatment for a low platelet count will be aimed at whatever condition is causing your reduced platelets. Read on to explore platelet causes, diagnosis, and treatment.
Causes of Low Platelet Counts
Low platelet counts can be caused by a variety of conditions that include:
Bone Marrow Issues
Bone marrow is the spongy tissue located within the bone. This is where the components of our blood are produced, including platelets.
When your bone marrow doesn’t produce platelets at a normal rate, you have a low platelet count. The causes of lower platelet production can include:
- Excessive alcohol consumption
- Exposure to toxic chemical, radiation, and chemotherapy
- Viral infections such as chickenpox, Epstein-Barr virus, and HIV
- Iron deficiency
- Folate deficiency
- Vitamin B-12 deficiency
- Aplastic anemia
A healthy platelet life cycle is between 7 and 10 days in the human body. Other than platelet production, a lower platelet count can be attributed to the destruction of platelets in the body. This can be caused by certain medications such as anti-seizure medicines and diuretics. Platelet destruction can also be a symptom of:
- DIC, or disseminated intravascular coagulopathy
- Hemolytic uremic syndrome
- TTP, or thrombotic thrombocytopenic purpura
- ITP, or idiopathic thrombocytopenic purpura
- Bacterial infection involved the blood
- Autoimmune disorder
- Enlarged spleen, or hypersplenism
Diagnosing a Low Platelet Count
If your physician suspects that you are suffering from a low platelet count, a physical examination will first be performed. During this examination, your physician will look for evidence of petechiae (rash) and unusual bruising.
Your physician may also check your abdomen for signs of an enlarged spleen, which is can be a cause of a lower platelet count.
Additionally, you may be asked if your family has a history with bleeding disorders since some of these symptoms can also be hereditary.
In order to fully diagnose a low platelet condition, your physician will need to perform a complete blood count (CBC). This type of blood test doesn’t just look at platelet count, but all of the blood cells located within your blood. This will inform your doctor if your platelet count is lower than average.
Your physician may also test your blood for platelet antibodies. These are the proteins located in the body that help to produce and destroy platelets as needed.
The overproduction of platelet antibodies can occur for unknown reasons or as a side effect of other drugs such as Plavix (clopidogrel).
Other tests related to blood clotting may also be requested, including prothrombin time (PT) and thromboplastin time (PTT). Both of these tests require a blood sample. Specific chemicals will be added to your sample to observe how long it takes to clot.
If during your physical examination, your physician suspects that your spleen is enlarged, they may schedule an ultrasound. Sound waves will then be used to create a picture of your spleen. This will help your physician determine if your spleen is of a healthy size.
Bone Marrow Aspiration and Biopsy
If you physician suspects there is a problem surrounding your bone marrow that is causing a lower than average platelet count, it is common to order an aspiration of your bone marrow. During this procedure, your physician will remove a small amount of bone marrow from a bone using a needle.
Additionally, a biopsy of your bone marrow may also be requested. To do this, your physician will need a sample of your core bone marrow.
Typically, this will be taken from the hipbone using a needle. This will be performed simultaneously with the aspiration.
Low Platelet Count Treatments
Treatment for a low platelet count will depend on the severity and cause of your diagnosed condition. If your condition is on the milder end of the spectrum, your physician may put on a hold on treatment in favor of observation and monitoring.
Your physician may also recommend that certain measures be taken in order to prevent your low platelet condition from worsening. This may include:
- Switching or stopping medications that negatively affect platelets, including ibuprofen and aspirin
- Limiting alcohol consumption
- Avoiding activities that have a high risk of bruising or bleeding
- Avoiding contact sports
If your lower platelet count is on the severe end of the spectrum, your doctor will require medical treatment. This could include:
- Surgical removal of the spleen, or splenectomy
- Drugs that suppress the immune system
- Corticosteroids to block platelet antibodies
- Immune globulin
- Change of medications
- Platelet or blood transfusions
Low Platelet Patient Outlook
Not all people who have been diagnosed with a lower platelet count require treatment. In some cases, a low platelet count can clear up on its own, returning to healthy and normal levels.
However, it is possible for patients that have severe cases to require treatment. In some cases, a platelet count can be fixed by addressing the underlying condition or cause. Your physician will work closely with you to develop a plan for treatment that helps in managing symptoms.