Our blood is made up of several types of cells, including red blood cells, white blood cells, and platelets, or thrombocytes. These cells are floating in a liquid called plasma. Red blood cells and white blood cells are equally important, so as with platelets in the blood.
If your skin is broken or injured, the platelets are clumping together, and they form clots to prevent excessive bleeding. If you don’t have enough platelets in the blood, your body will be less likely to form clots. Therefore, a high platelet count is necessary for that certain reason. This type of condition can range can exist from mild to severe, which will also depend on the underlying causes. The symptoms associated with a low platelet count can be fatal if not treated properly at the early stage of its existence.
But what is the most common cause of low platelet count? We will answer that question in this post.
Thrombocytopenia or low platelet count is considered as a medical condition. Platelets are the colorless blood cells that effectively help blood to clot. The platelets are the one stopping the bleeding by forming plugs in the blood vessels injuries. Thrombocytopenia is often occurring as the result of a separate disorder, like leukemia or problems in the immune system. At some point, it can also be a side effect if one takes a certain medication. Thrombocytopenia can affect not only the adults but also the children.
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Thrombocytopenia can come in mild and can cause few symptoms. In occasional cases, the number of the platelets might be too low to the point that it becomes dangerous to cause internal bleeding. Thrombocytopenia means you have a lower platelet count less than 150,000 per microliter in the blood. The condition can be inherited, or can also be acquired if the condition takes place, as the uses of drugs.
Those who are affected by thrombocytopenia should seek medical advice if they experience a single or more symptom. The doctors that you can consult for this condition may include hematologist, immunologist, internal medicine, and emergency medicine. The diagnosis of thrombocytopenia is confirmed by a blood test that will determine the count of your platelet. The available treatment of this condition will vary depending on its causes and the condition’s severity. The complications of thrombocytopenia might be severe to the point that it can damage your organs or worse, cause death.
Depending on the cause of the condition, low platelet count can be prevented. However, most of the causes it yields are unpreventable. But once treated early or effectively, the thrombocytopenia’s prognosis is typically good. Meanwhile, if the diagnosis is made later in the process of disease, the prognosis will decrease. But what is the common cause of a low platelet count?
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Common Cause of Thrombocytopenia (Low Platelet Count)
If for some reason the count of your platelet appears to be less than the normal number, it can now be called as thrombocytopenia. Normally, a certain person has a platelet count anywhere between 150,000 and 450,000 per microliter of the circulating blood. Since every platelet only lives for ten days, our body is continually renewing the platelet supplies by effectively producing new platelets in the bone marrow. Thrombocytopenia can either be inherited or can be a cause of different medications or other medical conditions. No matter what the cause is, the circulating platelets are effectively reduced by a single or more process.
The thrombocytopenia or low platelet count can be a cause of different reasons. Generally, the causes can be divided into three different categories, including increased platelet destruction, decreased platelet production, and increased splenic sequestration. But what is the most common cause of low platelet count in the mentioned categories? Among these three categories, it is the increased platelet consumption or destruction becomes the common cause of thrombocytopenia or low platelet count.
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Increased Platelet Consumption or Destruction – The Most Common Cause of Thrombocytopenia
Increased platelet consumption or destruction is the common cause of low platelet count or thrombocytopenia. They can be seen in different medical conditions, and they can be divided into immune and non-immune-related causes. Lots of medications may cause your platelet to count drop by causing an immunologic response against the platelets, namely drug-induced thrombocytopenia. Other examples may include:
- Sulfonamide Antibiotics
Certain medication may reduce the platelet count in the blood. Sometimes, drugs can confuse the immune system and may cause it to give destruction to the platelets. This will include Carbamazepine (Tegretol, Tegretol RX, Carbatrol, Eqetro), Digoxin (Lanoxin), Quinine (Quinite, QM-260, Quinerva), Quinine (Quinidex, Quinaglute), Acetaminophen (Tylenol), and Rifampin.
Hirapin is a blood thinner commonly used and is the same medication that can occasionally induce immune responses against your platelets, which can result in rapid and severe platelet destruction. This type of condition is termed as herapin-induced thrombocytopenia (HIT). HIT is developed about one or two days in the HIT type 1. Also, it is considered as a non-immune disorder because of the herapin platelet activation’s direct effect.
However, the HIT type 2 is the immune-mediated disorder, which occurs nearly four to ten days after the exposure to herapin. It can be developed into limb-and life-threatening complications. This is not usually marked by a bleeding issue, but the pulmonary embolism or DVT. The diagnosis is primarily based on the clinical findings and is supported by lab findings.
- Idiopathic Thrombocytopenia Purpura (ITP)
ITP is a condition in which the immune system clash against the platelets. In a more severe circumstance, ITP may result in a very low platelet count. For adult people, often, this is a chronic and long-standing condition, whereas in youngsters it can be acute causes after in existence of viral infection. Usually, this is a diagnosis of exclusion, which means other causes have to be ruled out.
- Systematic Lupus Erythematosus (SLE)
SLE and other autoimmune conditions or connective tissue diseases may also destroy the platelets. They are considered as rheumatologic conditions.
- Organ Transplantation and Blood Product Transfusion
The organ transplantation and blood product transfusion, at some point, can also cause immunologic disturbances that result to thrombocytopenia.
- Hemolysis, Elevated Liver Tests, Low Platelets (HELLP) Syndrome
HELLP is non-immune thrombocytopenia, which may take place during the pregnancy stage and may also include elevation of the liver enzymes and anemia.
- Hemolytic Uremic Syndrome (HUS) and Thrombotic Thrombocytopenia Purpura (TTP)
HUS and TTP are related to the conditions, which can be a reason of non-immune consumptive low platelet count, which results from infectious bacteria in your blood. Other manifestations of this condition may also include confusion, kidney insufficiency, anemia, and fever. The classic HUS is seen largely in kids and can generally be thought of as aftermath of infection with strain of the Escherichia Coli bacteria.
- Disseminated Intravascular Coagulopathy (DIC)
DIC is an occasional condition but can be severe at the same time. It is the complication of the overwhelming infections, burns, traumas, or even pregnancy. The thrombocytopenia caused by pregnancy can usually come mild and can be improved after giving birth.
- Severe Infections or Trauma
Trauma and severe infections like sepsis can sometimes cause a consumptive low platelet count.
- Injury or Inflammation of the Blood Vessels
The injury or inflammation of the blood vessels (vasculitis), as well as artificial heart valves, may also cause to increase the platelet destructions.
Some of the conditions under increased breakdown of platelets can cause one’s body to consume or destroy more rapidly compared to the amount of what they produced. This will lead you to a platelet shortage in the bloodstream. Dangerous internal bleeding may happen when the count of your platelet falls less than 10,000 platelets per microliter. Though this might be rare, the severe thrombocytopenia can cause internal bleeding into your brain, and it can be fatal.
Other Causes of Thrombocytopenia
As what we have mentioned earlier on what is the most common cause of low platelet count, we have categorized the causes of thrombocytopenia into three, and we said that it is the increased platelet consumption or destruction is the main cause of low platelet count. We believe that you should know what the rest of the thrombocytopenia causes are and what they cover.
Decreased Platelet Production
The platelets are being produced in the bone marrow and decreased platelet production is related basically to it. In some of the conditions under this, the production of the red blood cells and the white blood cells can also be affected. If the production is getting low, there is a possibility of developing thrombocytopenia. Some of the factors the can lower the platelet production include:
- Viral Infections that Affect the Bone Marrow
- Hepatitis C
- Chicken Pox
- Epstein-Barr Virus
- Aplastic Anemia
This is a term generally used when your bone marrow fails to yield blood cells, including white blood, red blood, and platelets.
The chemo drugs are frequently causing suppression in the bone marrow, resulting in low platelet count.
- Thiazide Diuretics
Apart from chemo drugs, this drug can also contribute to the platelet production suppression, which can cause to lower the count of your platelet count and eventually, lead to thrombocytopenia.
The cancers of the bone marrow and the blood, or the cancers of the lymph ph nodes can also cause different degrees of thrombocytopenia.
- Organ Cancers
Cancer in other organs can infiltrate or invade the bone marrow, which will result in impaired platelet production.
If you are taking alcohol for a long time, there is a big chance for you to encounter thrombocytopenia. The alcohol can cause direct toxicity to your bone marrow.
- Vitamin Deficiency
Some vitamins in the body are important so you can take sustain the platelet count in your blood. When you lack folic acid and Vitamin B12, the chances are your platelet count production will be affected in your bone marrow.
Therefore, many factors are affecting the production of the platelet in the bone marrow. Though, there is less chance for the cancers to be given a cure, which entirely affects the platelet count, some factors mentioned can be prevented since they are just a part of a bad habit.
This is another cause of thrombocytopenia. Splenic sequestration as well can lead to a low platelet count, as the result of change or enlargement in functions of spleen for some reasons. If your spleen is enlarging, there is a chance for it to retain more platelets than the usual and normal count is supposed to take. Common issues of the thrombocytopenia due to the splenic enlargement might include the advanced disease in the liver with portal hypertension and blood cancers.
- Dilutional Thrombocytopenia
This can result from severe bleeding, and the transfusion of different units transfused red blood in a short time.
This is a commonly experienced condition, in which the platelet counts seen on the complete blood count or CBC appeared falsely low due to the clumping together of the platelets. This might lead to the artificially lessened automated count. Once this is suspected, your blood could be redrawn in the tube with the materials, which prevent platelet clumping for repeat assessment.
Thrombocytopenia can be present, at the same time, in birth, which is called neonatal thrombocytopenia. Mostly, these cases are caused by the processes the same with the ones we have above, though they are rarely related to the occasional genetic conditions.
When to Seek Medical Attention for Thrombocytopenia?
If the thrombocytopenia is effectively detected on the routine blood work, generally, it is investigated and addressed by your physician who requests for the test. For people with thrombocytopenia, the follow-up care will be decided according to the severity and diagnosis. However, if you have more symptoms, you need to seek medical attention from professionals since thrombocytopenia can quickly become serious in other individuals.
Those who have thrombocytopenia, in general, are initially cared for by a family practice doctor. Sometimes, a consultation with the specialized blood disorder doctors can be helpful to have a thorough investigation and treatment. In some cases, other patients may require additional help than just these.