THROMBOCYTOPENIA

General Information

DEFINITION--A decrease in the circulating number of platelet cells in the blood. Platelets play a vital role in the control of bleeding by plugging any small breaks that occur in the walls of blood vessels. With thrombocytopenia, there is a tendency to bleed, particularly from the smaller blood vessels. This causes abnormal bleeding into the skin and other body parts.

BODY PARTS INVOLVED--Blood, which affects all body parts.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Petechiae (round, nonraised, purple-red spots on the skin).
• Bruising tendency; bleeding in the mouth; nosebleeds.
• Heavy or prolonged menstrual periods; blood in the urine (if bleeding is prolonged).

CAUSES

• Congenital (present at birth).
• Decreased or defective production of platelets in the marrow.
• Sometimes the cause is unknown (idiopathic).

RISK INCREASES WITH

• Acute infection; HIV infection.
• Taking aspirin or other nonsteroidal anti-inflammatory drugs; taking drugs such as quinidine, sulfa preparations, oral antidiabetic agents, gold salts, rifampin, etc.
• Hypersplenism; hypothermia; blood transfusion.
• Excess alcohol consumption.
• Pre-eclampsia.
• Other diseases such as systemic lupus erythematosus, anemia, leukemia, cirrhosis.
• Exposure to x-ray or radiation.

HOW TO PREVENT

• Avoid medications, when possible, that are a risk factor.
• For patients with thrombocytopenia, avoid trauma and seek treatment if trauma occurs.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood studies that show low number of platelets.

APPROPRIATE HEALTH CARE

• No treatment may be necessary in some cases and the thrombocytopenia is allowed to run its course.
• Other treatment programs vary depending on the underlying cause.
• Discontinuance of the offending drug in drug-induced thrombocytopenia.
• Surgery to remove the spleen.
• Platelet transfusions for patients with serious hemorrhage or anticipating major surgery and in some chronic thrombocytopenic patients.

POSSIBLE COMPLICATIONS

• Severe blood loss.
• Pneumococcal infection.
• Adverse effects of drug therapy.

PROBABLE OUTCOME--

• For acute cases, particularly in children, most recover within two months.
• Chronic cases may have remissions and relapses, some recover spontaneously.

How To Treat

GENERAL MEASURES--

• To stop bleeding at any accessible site, apply cold compresses or ice packs and pressure until bleeding stops. If nosebleeds are a problem, humidify your air. Use a cool-mist, ultrasonic humidifier. Clean humidifier daily.
• Inform any doctor or dentist who treats you that you have thrombocytopenia.
• Avoid surgery, including dental surgery, unless it is essential. Practice good dental hygiene. Also, avoid injections. If a shot is necessary, apply pressure continuously to the injection site for 5 minutes.
• Monitor your skin condition. Look for any signs of petechiae (round, nonraised, purple-red spots on the skin) or bruising. Have someone else check the skin areas you cannot see.
• Avoid injury whenever possible.
• Wear a Medic-Alert (See Glossary) bracelet or neck tag that indicates your medical problem and any medications you take.

MEDICATION--Your doctor may prescribe:

• Corticosteroids at time of diagnosis and in relapsing cases; gamma globulin during acute phase of a severe episode; immunosuppressive therapy in persistent cases.

ACTIVITY--

• Bed rest during acute phase.
• Minimal activity to prevent injury.
• Avoid contact sports.

DIET--No special diet.

Call Your Doctor If

• The following occurs during treatment: Bleeding that can't be stopped. Enlargement of the abdomen. Black, tarry stools or vomit that looks like coffee grounds. A rash (described under Signs & Symptoms)--especially with fever.
• New, unexplained symptoms develop.