Symptoms of Thrombocytopenia
Usually, thrombocytopenia causes no symptoms. Thrombocytopenia is most often detected incidentally on blood tests obtained routinely or for other reasons.
When thrombocytopenia causes symptoms, they can include:
- Bleeding, most often from the gums or nose. In women, menstrual bleeding may increase or occur more often between periods.
- Petechiae, which are red, flat spots on the skin, about the size of a pinhead. Petechiae are most prominent on the legs and feet, and may occur in clumps.
- Purpura, which are larger areas of bleeding under the skin that can appear as blotches that don’t turn white when pressed upon.
- Ecchymoses, or areas of bleeding into the skin. Identical in appearance to bruises, ecchymoses are blue or purple, changing colors to yellow or green over time.
Severe thrombocytopenia can result in major bleeding after an injury, such as a car accident or a fall.
Thrombocytopenia does not generally cause excessive bleeding after injuries unless platelets fall below 50,000 per microliter. Spontaneous major bleeding does not occur until platelets fall very low -- less than 10,000 or 20,000 per microliter. Minor bleeding (as from the gums or nose) may occur at higher platelet counts.
Treatments for Thrombocytopenia
Thrombocytopenia by itself rarely requires treatment, because low platelets do not usually cause any problems. In general, treatment for thrombocytopenia is centered on treating the condition causing the low platelet count.
- Immune thrombocytopenia (such as idiopathic thrombocytopenic purpura) is often treated with corticosteroids, such as prednisone or other drugs.
- Surgical removal of the spleen (splenectomy) may be recommended for severe immune thrombocytopenia. When the spleen is absent, it can't isolate large numbers of platelets from the bloodstream.
- When a medication side effect causes thrombocytopenia, stopping the drug generally returns platelet counts to normal.
- Vitamin B12 and folate are given to correct thrombocytopenia caused by deficiencies of these vitamins.
- For certain rare causes of thrombocytopenia, blood thinners such as warfarin may actually be needed to prevent blood clots.
When platelets drop to very low levels (less than 10,000 or 20,000 per microliter of blood), platelet transfusions can prevent bleeding. If thrombocytopenia is present with significant bleeding, platelet transfusion is often necessary to stop the bleeding.