Thrombocytopenia (Low Platelet Count)

Thrombocytopenia is when you don't have enough platelets, cells in your blood that stick together to help it clot. Sometimes, the condition doesn’t cause any problems at all. But if you have symptoms like too much bleeding, treatment can help.

Thrombocytopenia Causes

Your bone marrow, the spongy tissue inside your bones, makes platelets. You can get thrombocytopenia if your body doesn't make enough of them or if it destroys them faster than you can replace them.

Your body might not make enough platelets if you:

Your body can destroy too many platelets because of:

Sometimes, you don't have enough platelets because they get trapped in your spleen, an organ that fights infection. And women may get thrombocytopenia during pregnancy because their bodies get rid of platelets more quickly than usual.

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Thrombocytopenia Symptoms

Sometimes, you don't have any symptoms from thrombocytopenia. When you do, the main problem is bruising and bleeding in your skin that looks like tiny red or purple spots, called petechiae.

You can bleed outside or inside your body. Sometimes, it can be heavy or hard to stop.

You might also have:

These symptoms might not start until your platelet count is very low. Tell your doctor about them right away.

Thrombocytopenia Diagnosis

Your doctor will ask about your medical history and symptoms. They’ll look for bruises, petechiae, and other signs of low platelets. They’ll also check for signs of infection, like a fever or rash.

You might have a blood test that measures how many platelets you have. Most people have 150,000 to 450,000 platelets per microliter of blood. You can have bleeding problems if your count drops below 50,000.

Your doctor will most likely consult with a blood specialist (hematologist). You might get other tests, including:

  • A blood smear to look at your platelets under a microscope and see how healthy they are
  • A bone marrow test to see what cells are in the marrow, how full the marrow is with cells, and whether they are normal
  • Tests to check that your blood clots the way it should

Thrombocytopenia Complications

When your platelet count falls below 50,000, you might have especially heavy bleeding after an injury. Below 30,000, even a minor injury may cause a lot of bleeding.

If your platelet count falls below 10,000, you can have dangerous internal bleeding without an injury. Rarely, you may also have life-threatening bleeding in your brain.

Thrombocytopenia Treatment

If your platelet count isn't too low, you might not need treatment.

Sometimes, your platelet count will go up when you avoid the cause of the problem. For instance, if a certain medicine is behind your thrombocytopenia, your doctor will probably have you stop taking that drug.

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For severe thrombocytopenia, your doctor might give you:

  • Steroid medicines to keep your body from destroying platelets if the problem is related to your immune system
  • Intravenous immune globulin (IVIG) if you can’t take steroids or if you need a higher platelet count quickly
  • Blood or platelets from a healthy person, called a transfusion
  • Surgery to remove your spleen

If your condition continues despite other treatments, your doctor may prescribe medicines such as eltrombopag (Promacta, Revolade), fostamatinib (Tavalisse), and romiplostim (Nplate).

To prevent bleeding when your platelet count is low:

  • Don’t take medicines that can affect how well your platelets work, like aspirin and ibuprofen.
  • Limit how much alcohol you drink, because it can make bleeding worse.
  • Don't take part in contact sports, like football or boxing, in which you might get injured.
  • Use a soft toothbrush to protect your gums.
  • Wear a seatbelt when you’re in a car, and put on gloves and goggles when you work with power tools to prevent injury.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on January 21, 2020

Sources

SOURCES:

American Family Physician: "Thrombocytopenia."

American Society of Clinical Oncologists: "Thrombocytopenia."

Cleveland Clinic: "Thrombocytopenia."

National Heart, Lung, and Blood Institute: "Thrombocytopenia"

Mayo Clinic: “Thrombocytopenia (low platelet count).”

UpToDate: “Immune thrombocytopenia (ITP) in adults: Initial treatment and prognosis.”

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