Thrombocytopenia

Thrombocytopenia is a condition that affects your blood. It can make you bruise easily or bleed more after an injury.

At Banner Health, we provide expert care for people with thrombocytopenia. We work with you to find the best treatment plan for your needs. Keep reading more about thrombocytopenia, how it is diagnosed and how we can help.

What is thrombocytopenia?

Thrombocytopenia means you have a low number of platelets in your blood. Platelets are small cell fragments that help form clots, stopping bleeding when you are injured. 

When you cut or injure yourself, platelets gather at the site and form a clot or plug. This helps stop the bleeding. If you have thrombocytopenia, your blood may not clot properly, and you may bleed more than usual after an injury or surgery. In severe cases, this can lead to internal bleeding, including bleeding in your brain, which can be life threatening.

What are normal platelet levels in the blood?

In healthy people, blood contains between 150,000 to 450,000 platelets per microliter. Thrombocytopenia occurs when levels fall below 150,000. 

There are three levels of thrombocytopenia:

• Mild thrombocytopenia: Platelet levels between 101,000 and 150,000 
• Moderate thrombocytopenia: Platelet levels between 51,000 and 100,000
• Severe thrombocytopenia: Platelet levels 50,000 or lower 

What causes thrombocytopenia and who is at risk?

A low platelet count can happen when your bone marrow can't make enough platelets or when medical issues destroy or trap them. 

Common causes include:

• Bone marrow disorders: Your bone marrow is where your blood cells are made, including platelets. Conditions like leukemia and  can affect your body’s ability to produce platelets. 
• Medications: Certain medications like chemotherapy, antibiotics and blood thinners can lower your platelet count.
• Infections: Viral infections like hepatitis, COVID-19 or the flu reduce platelet counts. 
• Autoimmune diseases: Conditions like lupus or immune thrombocytopenia purpura (ITP) can cause your immune system to attack and destroy platelets. 
• Pregnancy: Some women develop mild thrombocytopenia during pregnancy, which usually gets better after birth.
• Alcohol use disorder: Excessive drinking can harm platelet production.

Some people are more at risk of developing thrombocytopenia based on their lifestyle or existing health conditions. 

Key risk factors include:

• Family history of blood disorders 
• Existing medical conditions like cancer, liver disease or HIV
• Age (some causes of thrombocytopenia are more common in older adults)
• Being exposed to certain chemicals like pesticides or industrial toxins

Signs and symptoms of thrombocytopenia

Some people with mild thrombocytopenia may not have any symptoms. When symptoms appear, they can include: 

• Easy bruising
• Small red or purple dots on the skin (petechiae)
• Splotches of reddish-purple (purpura)
• Bleeding gums or other areas in the mouth
• Nosebleeds
• Blood in urine, stool, mucus and/or vomit
• Heavy menstrual periods

People with severe thrombocytopenia may have an increased risk of internal bleeding and heart attack. It may cause gastrointestinal bleeding or bleeding in your brain. Thrombocytopenia may decrease the amount of blood flow to your heart.

If you notice any signs of bleeding, it's important to get medical care right away.  

How is thrombocytopenia diagnosed?

Because thrombocytopenia shares symptoms with other medical conditions like anemia or hemophilia, it can be harder to diagnose.

Your provider may recommend:

• Complete blood count (CBC): A CBC measures the number of platelets and other cells like red blood cells.
• Blood smear: A closer look at your blood under a microscope to check the appearance and number of platelets.
• Bone marrow tests: These tests check if your marrow is making enough platelets.
• Other blood tests: These can help find infections, autoimmune diseases or clotting problems.

Knowing your full medical history also helps your provider diagnose the cause of low platelet levels. 

How is thrombocytopenia treated?

The treatment for thrombocytopenia depends on its cause and how severe the condition is. Mild cases may require no treatment, while severe cases often do.

Options include:

• Medications: Drugs that calm the immune system may be used for ITP.
• Platelet transfusions: Used when platelet counts are dangerously low or bleeding is severe.
• Plasma exchange (plasmapheresis): This treatment is used for thrombotic thrombocytopenic purpura (TTP), a rare, life-threatening condition.
• Immunoglobin therapy: IV immunoglobulin (IVIG) can boost platelet counts quickly.
• Treating underlying issues: Treating infections, liver disease or cancer may improve platelet counts.  
• Surgery to remove your spleen: In some cases, removing the spleen helps raise platelet counts. Splenectomy is performed when your spleen is trapping a large number of platelets.

How can you living with thrombocytopenia?

Most people with thrombocytopenia can manage their condition and live full lives. It’s important to follow your health care provider’s advice and follow any treatments. 

Here are some tips for living with thrombocytopenia:

• Be careful to avoid injuries: Since your blood doesn’t clot well, you’re at higher risk for bleeding. Try to avoid activities that could lead to cuts or bruises. Avoid contact sports and wear your seatbelt while driving or riding in a vehicle.
• Take medications as prescribed: If your provider gives you medicine, take it exactly as directed. 
• Use caution with pain medication: Over-the-counter (OTC) pain medicines like ibuprofen and aspirin can prevent platelets from working properly. Talk to your provider before taking this type of medication.
• Quit smoking: Smoking increases your risk of blood clots.
• Drink in moderation: If you drink alcohol, do so in moderation. Heavy alcohol use may affect platelet levels. 
• Use soft bristles: Use a soft toothbrush to prevent bleeding gums. Be careful when flossing.
• Watch for signs of bleeding: If you notice any unusual bruising or bleeding, contact your provider right away.

By making lifestyle adjustments and working closely with your health care team, you can manage thrombocytopenia and reduce your risk of complications.

How Banner Health can help

If you think you may have thrombocytopenia or have been diagnosed with a low platelet count, don’t wait to get help and support. Banner Health’s team of specialists is here for you.

Schedule an appointment today to get started on a treatment plan that’s right for you.