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Thrombocytopenia

Getting a Diagnosis

Thrombocytopenia is often found by chance when your doctor does a routine blood test. He or she might ask you:

  • What symptoms have you noticed?
  • When did you first see them?
  • Does anything make them better? Or worse?
  • What medications and supplements are you taking?
  • Have you had any shots in the last month, a blood transfusion, or used drugs with a needle?
  • Does anyone in your family have a problem with their immune system, bleeding, or bruising?
  • What have you eaten recently?

Your doctor may do a physical exam to check you for bleeding and feel if your spleen seems big. Some tests check for low platelet levels:

CBC (complete blood count). This measures the amount of your red and white blood cells and platelets.

Blood smear. This shows how your platelets look under a microscope.

Bone marrow test. Your doctor may use a very fine needle to draw a small amount of liquid bone marrow and check it for cells that may not be working right. Or you may get a biopsy, using a different kind of needle, so your doctor can check the types and numbers of cells in the bone marrow.

You may need more tests to help your doctor figure out what's going on.

Questions for Your Doctor

  • What's causing the problem?
  • What are my treatment options? Which do you recommend?
  • Do these treatments have side effects? What can I do about them?
  • How will we know if the treatment is working?
  • When will I start to feel better?
  • What do you expect for my case?
  • Does this condition put me at risk for anything else?
  • Do I need to see a specialist?

Treatment

Finding the cause of your thrombocytopenia will help your doctor decide how to treat it.

Platelet counts generally return to normal when you stop taking certain drugs. Or you may need to take vitamin B12 or folate.

If your thrombocytopenia is from an infection, treating the infection helps.

Steroids, such as prednisone, and other drugs can help treat idiopathic thrombocytopenic purpura (ITP). Mild ITP usually goes away without any treatment.

If you have severe thrombocytopenia, your doctor may recommend surgery to remove your spleen.

Up to 5% of healthy women get thrombocytopenia when they're pregnant. It usually gets better on its own after the baby is born.

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