Thrombocytopenia
Low platelet count - thrombocytopeniaThrombocytopenia is any disorder in which there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is sometimes associated with abnormal bleeding.
Causes
Thrombocytopenia is often divided into 3 major causes of low platelets:
- Not enough platelets are made in the bone marrow
- Increased breakdown of platelets in the bloodstream
- Increased breakdown of platelets in the spleen or liver
Your bone marrow may not make enough platelets if you have any of the following conditions:
- Aplastic anemia (disorder in which the bone marrow does not make enough blood cells)
Aplastic anemia
Aplastic anemia is a condition in which the bone marrow does not make enough blood cells. Bone marrow is the soft, tissue in the center of bones tha...
Read Article Now Book Mark Article - Cancer in the bone marrow, such as leukemia
Leukemia
Leukemia is a type of blood cancer that begins in the bone marrow. Bone marrow is the soft tissue in the center of the bones, where blood cells are ...
Read Article Now Book Mark Article - Cirrhosis (liver scarring)
- Folate deficiency
Folate
Folate deficiency means you have a lower-than-normal amount of folic acid, a type of vitamin B, in your blood.
Read Article Now Book Mark Article - Infections in the bone marrow (very rare)
- Myelodysplastic syndrome (bone marrow does not make enough blood cells or makes defective cells)
- Vitamin B12 deficiency
Use of certain drugs may also lead to a low production of platelets in the bone marrow. The most common example is chemotherapy treatment.
The following health conditions cause increased breakdown of platelets:
- Disorder in which the proteins that control blood clotting become over active, most often during a serious illness (DIC)
DIC
Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become overactive.
Read Article Now Book Mark Article - Drug-induced low platelet count
- Enlarged spleen
- Disorder in which the immune system destroys platelets (ITP)
ITP
Immune thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clot...
Read Article Now Book Mark Article - Disorder that causes blood clots to form in small blood vessels, causing a low platelet count (TTP)
TTP
Thrombotic thrombocytopenic purpura (TTP) is a blood disorder in which platelet clumps form in small blood vessels. This leads to a low platelet cou...
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Symptoms
You may not have any symptoms. Or you may have general symptoms, such as:
- Bleeding in the mouth and gums
- Bruising
- Nosebleeds
- Rash (pinpoint red spots called petechiae)
Other symptoms depend on the cause.
Exams and Tests
Your health care provider will perform a physical exam and ask about your medical history and symptoms. The following tests may be done:
- Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark Article - Blood clotting tests (PTT and PT)
PTT
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem...
Read Article Now Book Mark ArticlePT
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. It measures the functio...
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Other tests that may help diagnose this condition include bone marrow aspiration or biopsy.
Treatment
Treatment depends on the cause of the condition. In some cases, a transfusion of platelets may be required to stop or prevent bleeding.
Outlook (Prognosis)
The outcome depends on the disorder causing the low platelet counts.
Possible Complications
Severe bleeding (hemorrhage) is the main complication. Bleeding may occur in the brain or gastrointestinal tract.
When to Contact a Medical Professional
Call your provider if you experience unexplained bleeding or bruising.
Prevention
Prevention depends on the specific cause.
References
Abrams CS. Thrombocytopenia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 163.
Arnold DM, Zeller MP, Smith JW, Nazy I. Diseases of platelet number: immune thrombocytopenia, neonatal alloimmune thrombocytopenia, and posttransfusion purpura. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 131.
Calihan J. Hematology. In: Kleinman K, Mcdaniel L, Molloy M, eds. Harriet Lane Handbook: The John Hopkin's Hospital. 22nd ed. Philadelphia, PA: Elsevier; 2021:chap 14.
Warkentin TE. Thrombocytopenia caused by platelet destruction, hypersplenism, or hemodilution. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 132.
Review Date: 1/25/2022
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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