Thrombocytopenia - Causes, Symptoms, Diagnosis and Treatment

Thrombocytopenia: Low Blood Platelet Count

Dr.Shyam A Rathi profile Authored by Dr.Shyam A Rathi on 9 Feb 2015 - 11:03.

Thrombocytopenia

Thrombocytopenia is a state of low blood platelet count causing a variety of symptoms and health issues. The normal blood platelet count ranges from 150,000 to 400,000 per microliter of circulating blood while Thrombocytopenia implies to the count dropped below 150, 000. Platelets are one of the important components of blood and it is responsible for blood clotting and preventing blood loss.

Thrombocytopenia can result from reduced platelet production, excessive platelet destruction or splenic sequestration, which is often linked to a variety of health conditions, high risk medications or family history. The severity of the condition may vary from mild with very few or no signs and symptoms, to life threatening condition. Usually, it does not cause any problem until the count falls down significantly, leading to excess blood loss and may be internal bleeding.

 

 

Following are the probable causes or conditions that might be responsible for low blood platelet count.

  • Enlargement of the spleen (responsible for filtering unwanted material from the blood) causing deficiency of platelets.
  • Reduced platelet production caused due to:
  • Leukaemia
  • Anemia (some forms)
  • Viral infections, e.g. AIDS, parvovirus, hepatitis C, chicken pox, etc.
  • Chemotherapy for cancer
  • Exposure to toxic chemicals
  • Excessive destruction of platelets and comparatively least production, this may be caused due to:
  • Being pregnant
  • Idiopathic thrombocytopenic purpura (ITP)
  • Thrombotic thrombocytopenic purpura (TTP), a condition causing multiple blood clots in the body 
  • Rheumatoid arthritis
  • Lupus
  • Various bacterial infections
  • Hemolytic uremic syndrome
  • Adverse reaction of several high risk drugs and medications including some antibiotics, anti-malarial drugs like quinine and quinidine, and some anti epileptic drugs. 
  • Consuming lots of alcohol
  • Miliary TB
  • Heart bypass surgery
  • Preeclampsia

Complications:

Drastic fall in blood platelet count (below 10, 000) may cause internal bleeding, rarely bleeding in the brain and intestines, making it life threatening.

 

 

Common symptoms developed as a consequence of Thrombocytopenia may include:

  • Excessive bruising on the skin
  • Rashes (caused due to superficial bleeding)
  • Excessive bleeding from injured part
  • Nose bleeding
  • Gum bleeding
  • Appearance of blood in stools or urine
  • Excessive bleeding during periods
  • Excessive bleeding while surgical procedures

When to see a doctor?

If the above symptoms are worrying, you are experiencing an abnormally prolonged bleeding on normal cuts, don’t think twice to head for immediate medical attention.

 

 

 

In most of the cases, Thrombocytopenia is diagnosed accidentally while performing routine blood tests or while testing for other conditions. In rest, diagnosis may involve work-up including physical exam, assessment of clinical history, blood tests and some other tests.

  • Physical exam: Examine the body for rashes, enlarged spleen and other symptoms experienced that may indicate thrombocytopenia.
  • Assessment of medical history: To look for a history of thrombocytopenia in the family.
  • Blood test: To check for blood platelet count if dropped below normal range, which confirms the diagnosis of thrombocytopenia.
  • Other tests: Based on the signs and symptoms, a variety of tests and procedures may be considered to find out the underlying cause. E.g.FBC with differential and blood film, bone marrow biopsy, etc.

 

 

 

Ideal treatment of thrombocytopenia aims to treat the underlying cause which may need approaches, including drugs and medications, surgery or sometimes blood transfusion. Usually, milder forms of thrombocytopenia may not be bothersome and remain undiagnosed and so untreated. In severe cases, the following approaches may be implemented:

  • Drugs and medications: Depending upon the cause revealed, the doctor will choose most appropriate medication to treat the underlying cause.  E.g. corticosteroids to treat idiopathic thrombocytopenic purpura, immune suppressing medications, etc.
  • Surgery: If required, surgery may be needed to treat the underlying cause, when other interventions fail to correct it. E.g. splenectomy, to remove enlarged spleen.
  • Blood transfusions: In the case of severe low blood platelet count, healthy red blood cells (RBCs) or platelets may be transfused to correct the blood platelet level, thereby treating the symptoms.

Alternative treatments: Following over the counter preparations can be taken with experts’ advice.

  • Ashwagandha – in capsule form 2 cap 3 times a day
  • PunarnavaMandur – as a tablet twice daily
  • Rohitakarishta – syrup, twice daily (approximately 30 ml dose)
  • Amla – syrup with water (1:1), approx. 20 ml dose twice daily
  • Wheat grass juice(on empty stomach)
  • Papaya leaf juice – 20 ml dose, after each 2 hours, multiple times a day
  • Gotukola Capsules
  • Centellaasiatica (leaf juice)
  • Beetroot

(Note: Dr Shyam Rathi does not recommend these alternative treatments. It is recommended to consult respective experts before choosing any alternative treatment.)

Home remedies and preventive tips: The following interventions and self/ home remedies may help with one to cope up with the condition effectively and may help one to prevent the thrombocytopenia:

  • Protecting yourself from getting injured or cuts that may make you bleed
  • Limiting alcohol consumption
  • Avoiding high risk medications like aspirin, ibuprofen and some more. Talk to your doctor before you take any over the counter medicine.
  • Treating any bacterial or viral infection as early as possible

Diet Recommendations: Several foods and nutrition supplements may help one to improve the blood platelet count. Common recommendations may include:

Prefer eating:

  • Foods rich in vitamin K e.g. green leafy vegetables, frozen spinach, broccoli, mustard, beet greens, dried coriander, asparagus, pickles, soybeans and so on.
  • Foods rich in calcium, e.g. milk, cheese, yogurt, dark vegetables, etc.
  • Folic acid or vitamin B-9 supplements or foods rich in. E.g. orange juice, chickpeas, lentils and lima beans.
  • Foods rich in lean protein
  • Zinc supplements or foods rich in zinc or e.g. oysters, crab, chicken, etc.
  • Whole grains.

It is advisable to avoid:

  • Animal foods
  • Aspartame
  • Alcohol
  • Bitter lemon and other sources of quinine
  • Diet soda
  • Cakes and candy.

 

 

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.