What is thrombocytopenia?
Thrombocytopenia is a condition in which the body does not have a normal number of platelets in the blood.
Blood is made up of three major cell types:
- red blood cells, which carry oxygen throughout the body;
- white blood cells, which help fight infection; and,
- platelets, which stick together at the site of a cut or wound to form a clot to stop the bleeding.
People who have thrombocytopenia don’t have enough platelets to form a blood clot, and so they may bleed excessively when they are cut.
How does thrombocytopenia occur?
Blood cells (including platelets) are made in the bone marrow, the spongy tissue inside of bones. Certain factors may interfere with the body’s ability to make platelets. Under other circumstances production is normal, but platelets are removed prematurely from the blood. Causes of thrombocytopenia can include:
- a bone marrow disease or treatment for disease. For instance, diseases such as leukemia (cancer of the bone marrow and bloodstream) and lymphoma (cancer of the lymph system) can cause dysfunction of the bone marrow.
- aplastic anemia, a disease that prevents the bone marrow from making blood cells of all types
- radiation and chemotherapy treatment for cancer can damage the blood stem cells that eventually become blood cells.
- exposure to certain viruses, including Epstein-Barr, cytomegalovirus, hepatitis, and HIV
- an autoimmune disease (the body’s immune system attacks the body), such as immune thrombocytopenic purpura or ITP)
- an enlarged spleen (an organ that acts as a filter for the blood and helps the body fight infection). The enlarged spleen tends to trap platelets and prevent them from circulating in the bloodstream.
- heredity (the condition is passed down from a parent)
- exposure to toxic chemicals
- taking certain medications, such as certain antibiotics, cardiovascular drugs, and seizure medications
- drinking too much alcohol
What are the symptoms of thrombocytopenia?
The main symptom of thrombocytopenia is bleeding, either on the surface of the skin or inside the body. (In mild cases of thrombocytopenia, there may not be any symptoms.)
Symptoms of thrombocytopenia include the following:
- bleeding on various parts of the skin. You may have small red or purple spots called petechiae on your lower legs, or bruising that is purple, red, or brown (known as purpura).
- bleeding that doesn’t stop on its own, such as a nosebleed or bleeding from your gums when you brush your teeth
- heavier bleeding during menstrual periods
- internal bleeding, such as blood in the urine or stool or bleeding from the rectum
How is thrombocytopenia diagnosed?
If your doctor thinks you may have thrombocytopenia, he or she will take your medical history and perform a physical exam.
During the medical history, your doctor will ask about any prior or current illnesses, previous blood counts you may have had, and medications you are taking. He or she may also want to know if anyone in your family has had thrombocytopenia, and whether you have been exposed to any blood (including blood transfusions) or used any intravenous drugs.
During the physical exam, your doctor will check your skin for any signs of bleeding, small spots of blood (petechiae), or bruises (purpura or ecchymosis). He or she will also examine your abdomen to see if your spleen or liver are enlarged. You may also have an ultrasound or CT scan to see if your spleen is enlarged.
Your doctor will order certain blood tests, including a complete blood count and tests to see if your blood is clotting correctly. You may need a bone marrow biopsy. During a bone marrow biopsy, the doctor extracts bone marrow fluid and tissue with a needle and examines it for any abnormalities.
How is thrombocytopenia treated?
If your doctor feels that the thrombocytopenia is not a serious threat to your health, he or she may choose not to treat it.
Your doctor may decide to treat the thrombocytopenia by treating the disease or condition that is causing it. For instance, if you are taking a medication that is causing thrombocytopenia, your doctor may switch you to another medication. If the thrombocytopenia is caused by problems with your immune system, your doctor may prescribe steroids, immunoglobulin, or other medications. A platelet transfusion may be needed if your platelet count is extremely low. In some cases, the patient may have his or her spleen removed in order to keep it from destroying platelets. Because the spleen helps the body fight infection, removing it may place the person at higher risk for certain types of infections. Several vaccinations are given before splenectomy to help prevent infection.
Can thrombocytopenia be prevented?
While you may not be able to prevent thrombocytopenia, there are certain things you can do to lessen its effects, such as the following:
- Limit your intake of alcohol, since alcohol slows production of platelets.
- If you are taking any medications that may decrease your platelet count (including over-the-counter medications), talk to your doctor about switching to another medication.
- Avoid medications that can thin your blood, such as aspirin and ibuprofen.
- Try to avoid activities in which you might be injured and might bruise or bleed.
- If you get an infection, talk to your doctor.
- National Heart Lung and Blood Institute. What Is Thrombocytopenia? Accessed 2/21/2013
- American Society of Clinical Oncology (Cancer.net). Thrombocytopenia. Accessed 2/21/2013
- Diz-Kucukkaya R, Chen J, Geddis A, Lopez JA. Chapter 119. Thrombocytopenia. In: Prchal JT, Kaushansky K, Lichtman MA, Kipps TJ, Seligsohn U, eds. Williams Hematology. 8th ed. New York: McGraw-Hill; 2010. Accessed 2/21/2013
- Konkle B. Chapter 115. Disorders of Platelets and Vessel Wall. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012. Accessed 2/21/2013
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/20/2013…#14430