Low platelet count – Symptoms , Diagnosis, Treatment, and More

What is low platelet count (Thrombocytopenia)? 

A low blood platelet count is called thrombocytopenia. A normal platelet count is considered to be in the range of 150,000 to 400,000 platelets per microliter (mcL). Platelets are a type of blood cell that helps to clot blood.

When there is a cut or a wound, the platelets surround the wounded area and clot the blood immediately. This will stop the bleeding in the cut or wounded area.

When there is a low platelet count, it can lead to bleeding risk. Thrombocytopenia can affect anyone of any age. Pregnant women get affected with mild thrombocytopenia after childbirth.

There are three types of thrombocytopenia.

• The first thrombocytopenia occurs when there is an autoimmune disorder. The platelets will be destroyed by your own immune cells and hence there will be a reduction in your platelet count.
• For people affected with liver or spleen diseases, their platelets will be sequestered.
• There will be reduced production of platelet in the bone marrow. This is related to bone marrow disease.

Symptoms

Symptoms of thrombocytopenia are common and people with mild thrombocytopenia will have fewer or no symptoms.

The common symptom of low blood platelet count is excess bleeding even when you had a small cut. The other symptoms are briefed below.

Easy or excessive bruising (purpura)

Easy or excessive bruising can happen when you have less or a low platelet blood count. Purpura is also called immune thrombocytopenic purpura. Purpura is a bruise caused in the skin that appears purple.

Purpura is a common disorder that occurs in both adults and children. There are two types of immune thrombocytopenic purpura.

• Acute thrombocytopenic purpura and
• Chronic thrombocytopenic purpura.

The acute thrombocytopenic purpura affects children. They have symptoms like chickenpox. This purpura appears all of a sudden and the disorder subsides on its own after six months.

Unlike the acute thrombocytopenic purpura, chronic thrombocytopenic purpura occurs at any age. This disorder affects females more than males. The disorder can occur at any age and last for a minimum of six months and to a maximum of years.

Chronic thrombocytopenic purpura can recur often and proper medical care is required to control the symptoms.

Some of the common symptoms of purpura are

• Nosebleeds
• Heavy menstrual bleeding
• Blood in stools and urine and
• Small red dots under the skin

The most critical symptom of purpura is bleeding in the brain. If there is a head injury and there is a low platelet count, the patient can die of over bleeding. Bleeding in the brain can be life-threatening and fatal.

Prolonged bleeding from cuts

A low platelet count can cause prolonged bleeding when you have a small cut. When your platelet count is below 10000/microliter you might have spontaneous bleeding.

Usually, people with a platelet count of less than 20000/mL are likely to have spontaneous bleeding.

Bleeding from your gums or nose

Nose bleeds are common but can be scary. Nose bleeds can indicate a significant medical condition like thrombocytopenia.

The nose contains many small fragile blood vessels that easily bleed when hurt. So nose bleeds are common symptoms of thrombocytopenia.

Occasional bleeding of gums can be caused due to bruises from brushing but when you bleed often it might indicate certain health conditions like low platelet count or lack of blood-clotting cells.

Blood in urine or stools

The medical term for blood in urine is called hematuria. Many health conditions can cause hematuria like infection, cancer and blood disorders.

At first, the blood can be in spots, and later it can be visible to your naked eye. When you have a low blood platelet count blood it reflects in the urine that will be a visible symptom.

Blood in stools can indicate gastrointestinal tract problems. These bleeds can be alarming and can signify stomach cancer. If you have a low blood platelet count, blood in stools can be a common symptom.

Unusually heavy menstrual flows

When you have a low blood platelet count there will be less or a lack of blood-clotting cells. So, there will be more blood flow during the menstrual cycle and clotting happens very less.

Fatigue

Low blood platelet count can cause extreme fatigue.

Enlarged spleen

An enlarged spleen can be caused due to other medical conditions like Liver cirrhosis and Gaucher disease.

The spleen becomes enlarged and it traps the platelet and other blood cells. As a result, the cells that circulate in the bloodstream decreases.

Causes

Thrombocytopenia can be caused by various factors and in rare cases, it is inherited. Some of the common causes of a low platelet count are listed below.

Viral infections (including chickenpox, parvovirus, hepatitis C, Epstein-Barr, and HIV)

Viral infections can trigger  an immune response and can interfere with platelet production. The viral infection activates the inflammatory response and the platelet-activating mediators.

In this process, the platelets get used up and there will be a decrease in the platelet count.

Systemic lupus erythematosus (SLE)

Systemic lupus erythematosus (SLE) is a common autoimmune disorder that causes severe fatigue and joint pain. SLE causes frequent thrombocytopenia and its consequences are severe.

Chronic lymphocytic leukaemia (CLL)

Chronic lymphocytic leukaemia is a type of cancer that affects the blood and bone marrow. Leukaemia progresses slowly and becomes a chronic condition.

Chronic lymphocytic leukaemia is an autoimmune disorder. The immune system destroys its own healthy platelet count which leads to low platelet count.

Drug-induced immune thrombocytopenia

There are drugs that destroy the healthy platelet and are called drug-induced thrombocytopenia. These drugs cause the body to produce antibodies that destroy the platelet. As a result, there will be a low platelet count.

Sepsis

Sepsis is classified as a life-threatening infection. When there is a foreign invasion the body produces antibodies that destroy its own platelet cells.

The sepsis infection can lead to a sudden septic shock that can be fatal.

Helicobacter pylori (H. pylori)

Helicobacter pylori is an infection that lives in the intestine and causes gastrointestinal problems. These infections lead to low platelet count and eradication of the infection can avoid thrombocytopenia.

Diagnosis

There are many diagnosis methods for thrombocytopenia. The test will be suggested by your doctor depending on your health condition.

Bone marrow test

The bone marrow test is performed to diagnose the platelet count. There are two types of bone marrow tests.

• Biopsy
• Aspiration

A biopsy test collects a sample of your core bone marrow from your hipbone whereas an aspiration collects a sample of bone marrow from your bones.

Complete blood count (CBC)

The complete blood count test will help to find the total platelet count. The test also determines the overall blood count and also indicates if there is any infection and other conditions like anaemia and leukaemia.

Blood smear test

The blood smear test helps to determine the shape of the cell. This test determines if the cells are normal or damaged. A blood smear test also helps to indicate the presence of parasites.

Other blood tests to assess blood clotting

Other tests like the coagulation test are performed to test the ability of your blood to clot.

Conclusion

Thrombocytopenia can occur to anyone. So, always be watchful of your symptoms.

Consult your doctor if you have any unusual symptoms. Thrombocytopenia can be fatal if left untreated. It causes internal bleeding in the brain or intestines which can be life-threatening.

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