Platelets are small particles of the blood that are responsible for blood clotting. They are shaped like a disk and have no nucleus. It played a significant role when a person got injured. They will receive chemical signals from the blood vessels, allowing them to clump together in the wounded area to form a clot.
Thrombocytopenia is a condition in which the body has very low platelets traveling in the bloodstream. This disease happens when the body produces an abnormally low number of platelets, or they are destroyed before they get mature. Excessive bleeding can occur when this problem occurs.
The average rate of platelets that the body should have is between 150,000 to 450,000 per microliter of blood. Only ⅔ of this level should travel in the bloodstream while the remaining stay in the spleen. The platelets have a short life cycle. They just live between seven to 10 days. Therefore, the body should continuously produce more of these elements to replace the lost platelets.
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Signs of low platelet count
Take note that the following symptoms may not occur in mild cases. They can appear once the platelets can become extremely low.
- Nosebleeds, bleeding gums
- Blood found in the urine and stool
- A heavy menstrual period in women
- Hemorrhages in the skin
- Jaundice (yellowish skin and eyes which mostly appear on newborns)
- Excessive bleeding (can occur inside or outside of the body)
The causes of low platelet count can be due to three primary reasons:
- 1. Low production of platelets
The platelets and other essential particles of blood are manufactured in the bone marrow. It is the spongy tissue inside the bones. If this part is defective and cannot produce the needed level of platelets, thrombocytopenia occurs. Moreover, even the red and white blood cells will also be affected by this issue.
Several problems caused the bone marrow to malfunction:
Measles – this infectious disease exists when the rubella virus attacks the body. It can bring fever and rash that can affect children and adults. It can also cause joint pains, and the illness can also damage the bones.
HIV – also called human immunodeficiency virus, this disease can be transmitted and can spread in humans. It can attack the body’s defense cells that can weaken the immune system. It can also destroy even the antibodies that protect the body. As a result, the virus can enter the bone marrow in which the platelets are manufactured.
Hepatitis C – this disease is a contagious disease which can affect the muscles and cells. It can also weaken the manufacture of blood cells, including platelets.
Aplastic anemia – is a general term for bone marrow failure which is the primary cause of the low production of platelets. This condition may be due to virus, radiation, or congenital disorders.
- Increased destruction of platelets
In certain conditions, the platelets can be destroyed before they reach their maturity level. It can be the side effects of medicines, transfusions or rheumatologic reactions. We are also aware that the immune system should protect the body against invaders. However, due to certain medications, severe infections, and a condition called idiopathic thrombocytopenic purpura or ITP, the antibodies cannot recognize the platelets as part of the blood cells and mistakenly fight these elements.
- Spleen enlargement
Spleen enlargement can be due to liver cirrhosis or leukemia. If this condition occurs, the spleen captures more platelets than the average level. As a result, there are a few of them left to circulate in the blood.
Other causes of low platelet count can be contact with chemicals such as pesticides and paint, and disease that can be acquired from the family such as May-Hegglin syndrome and Wiskott-Aldrich. Pregnancy is also one of the common cause, but it can be treated by iron and folate supplements.
All these three conditions can affect both adults and children. These issues can be detected through blood testing. It will enable the medical professionals to understand the severity of the disease. A thorough investigation is needed to determine the conditions of the platelets in the body.
Sometimes, the platelets can mistakenly appear low in the blood smear. It can happen because they clump together while the blood is drawn. As a result, there are only a few of them that can be seen in the microscope. Its appearance can be confusing and can be mistakenly identified as thrombocytopenia. However, a repeat blood draw is advisable, but this time, the medical experts will use a different tube that prevents the clumping of platelets.
It is essential to check other sources before declaring that the condition is thrombocytopenia. A further investigation includes a review of medications being used, medical conditions, family history, and physical examinations. Even the use of alcohol will also be evaluated.
Different diagnostic tests will also be conducted such as a complete blood count (CBC), hemoglobin test, blood chemistry panel, and test for antibodies. Other methods like bone marrow biopsy can also help determine if aplastic anemia and leukemia are present which cause the low production of platelets.
The diagnosis plays a significant role in identifying the underlying cause of low platelet count as well as finding the appropriate treatment for this condition. Some medications that cause this problem should be discontinued to prevent further complications to occur. Removal of the spleen can also be recommended when the problem is due to spleen enlargement.
If bleeding spontaneously occurs, the doctor will most likely to offer platelet or whole blood transfusion to replace the lost and damaged platelets. In this case, the platelet count is less than 10,000 to 20,000 per microliter of blood. If the problem is due to a particular disease, then, the primary thing that should be treated is the disease itself.
Thrombocytopenia can be prevented if the underlying cause is preventable. If the problem is due to medication, then the doctor can prescribe a different drug. In mild cases, this condition can be controlled by having a balanced diet and taking iron and folate supplements.