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Thrombocytopenia

Thrombocytopenia is any disorder in which there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is sometimes associated with abnormal bleeding.

Causes

Thrombocytopenia is often divided into three major causes of low platelets:

  1. Not enough platelets are made in the bone marrow
  2. Increased breakdown of platelets in the bloodstream
  3. Increased breakdown of platelets in the spleen or liver

Your bone marrow may not make enough platelets if you have any of the following conditions:

  • Aplastic anemia
  • Cancer in the bone marrow, such as leukemia
  • Cirrhosis (liver scarring)
  • Folate deficiency
  • Infections in the bone marrow (very rare)
  • Myelodysplastic syndrome (bone marrow does not make enough blood cells or makes defective cells)
  • Vitamin B12 deficiency

Use of certain drugs may also lead to a low production of platelets in the bone marrow. The most common example is chemotherapy treatment.

The following health conditions cause increased breakdown of platelets:

  • Disseminated intravascular coagulation (DIC)
  • Drug-induced nonimmune thrombocytopenia
  • Drug-induced immune thrombocytopenia
  • Hypersplenism (swollen spleen)
  • Immune thrombocytopenic purpura (ITP)
  • Thrombotic thrombocytopenic purpura

Symptoms

You may not have any symptoms. Or you may have general symptoms, such as:

  • Bleeding in the mouth and gums
  • Bruising
  • Nosebleeds
  • Rash (pinpoint red spots called petechia)

Other symptoms depend on the cause.

Exams and Tests

Your health care provider will perform a physical exam and ask about your medical history and symptoms. The following tests may be done:

Other tests that may help diagnose this condition include bone marrow aspiration or biopsy.

Treatment

Treatment depends on the cause of the condition. In some cases, a transfusion of platelets may be required to stop or prevent bleeding.

Outlook (Prognosis)

The outcome depends on the disorder causing the low platelet counts.

Possible Complications

Severe bleeding (hemorrhage) is the main complication. Bleeding may occur in the brain or gastrointestinal tract.

When to Contact a Medical Professional

Call your healthcare provider if you experience unexplained bleeding or bruising.

Prevention

Prevention depends on the specific cause.

References

Abrams CS. Thrombocytopenia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 175.

Wong EY. Why does my patient have thrombocytopenia? Hematol Oncol Clin N Am. 2012;26:231–252.

Updated: 2/24/2014

Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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