Low platelet count: what does it mean?

Low platelet count: causes, symptoms and treatments

Thrombocytopenia, or low platelet count, is a condition that can be a sign of several diseases or problems.

Platelets are cells or cell fragments from the marrow, also called megakaryocytes, that circulate in the blood. They contribute to blood clotting, which means preventing bleeding and blood loss, as well as healing wounds such as cuts and sores, or fighting certain diseases such as cancer, for example.

In general, blood contains between 150,000 and 450,000 platelets per microliter. If the number of platelets is less than 150,000 per microliter of blood, we have a case of thrombocytopenia or low platelets. This condition can lead to more frequent bleeding.

Thrombocytopenia can be divided into several grades depending on the count: mild (100000-150000 platelets), moderate (50000-90000) and severe (


Causes

At the origin of the low platelet count can be:

  • Bone marrow alteration and megakaryocyte depletion, due to bone marrow aplasia, bone marrow fibrosis, and/or the effects of chemotherapy or radiation therapy;
  • Marrow infiltration by leukemic cells or other neoplasms;
  • Increased destruction of platelets by antibodies, as in immune thrombocytopenic purpura (ITP) or other autoimmune diseases such as lupus, or due to certain medications;
  • Severe infections or when there are changes in the bloodstream;
  • Anemia;
  • Increased spleen size (splenomegaly);
  • Heredity;
  • Toxic chemical exposure;
  • Heavy alcohol consumption.

Symptoms

One of the main functions of platelets is to control bleeding. Therefore, when platelet counts are low, symptoms may occur, such as:

  • Bruising (ecchymosis);
  • Minor hemorrhages on the skin (petechiae);
  • Heavy bleeding during menstruation;
  • Bleeding from nose or gums;
  • Evacuations or vomiting with blood;
  • Headache, joint or muscle pain;
  • Dizziness or weakness.

In cases where the platelet value is extremely low, hemorrhages can occur in the brain, which can be fatal.

Diagnosis

To diagnose this problem, the patient’s symptoms, family history, and medications should be considered.

In addition, it is important to perform a physical examination and blood tests, which assess the concentration of platelets in the blood.

In some situations, a bone marrow biopsy may even be necessary.

Treatment

Treatment of this low platelet problem depends on the origin of the problem.

In general, however, this treatment may include:

  • Corticosteroids;
  • Immunosuppressive drugs;
  • Monoclonal antibody;
  • Platelet transfusions.

Precautions to take

People with low platelet counts should take certain precautions, such as:

  • Avoid bruising or injury;
  • Be careful when handling scissors, knives, needles or other sharp tools;
  • Shave with a machine, not with blades;
  • Wear comfortable clothes and shoes that protect the body and feet;
  • Use a soft toothbrush and do not floss;
  • Blow your nose gently and with a soft tissue;
  • Know that you have a low platelet count, whenever you undergo a medical or health procedure;
  • Educate yourself about the risks of taking over-the-counter medications, taking into account that you have low platelets;
  • Avoid infections;
  • Squeeze the cut or bleeding area to stop the bleeding;
  • Seek medical attention as soon as you feel your condition worsening.

Low platelet count in newborns

Although less than 1% of newborns have low platelets, it is one of the most common hematologic problems (25% to 30%) in babies admitted to neonatal intensive care units.

In neonates, a platelet count of less than 100,000/µL is considered abnormal, regardless of the gestational age of the baby.

In infants, the causes of this problem may be congenital or acquired, and the most serious consequence is intracranial hemorrhage. Treatment of this problem involves transfusion of platelets, immunoglobulin and corticosteroids.

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