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 to learn more about thrombocytopenia 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 in your blood that help form clots to stop bleeding. 

When you cut or injure yourself, platelets gather at the site of the injury 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.

Levels of thrombocytopenia

In healthy people, blood contains between 150,000 and 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 between 51,000 and 21,000, or less

Causes and risk factors

Thrombocytopenia can happen for a variety of reasons. A low platelet count happens when your bone marrow can’t make enough platelets. It may also happen when medical issues destroy or trap platelets, preventing them from doing their job. 

Common causes for these are:

1. 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. 
2. Medications: Certain medications like chemotherapy, antibiotics and blood thinners can lower your platelet count.
3. Infections: Viral infections like hepatitis, COVID-19 or the flu reduce platelet counts. 
4. Autoimmune diseases: Conditions like lupus or immune thrombocytopenia purpura (ITP) can cause your immune system to attack and destroy platelets. 
5. Pregnancy: Some women develop mild thrombocytopenia during pregnancy, which usually gets better after birth.
6. 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. Others may notice signs like: 

• 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 symptoms of thrombocytopenia, talk to your health care provider. They can help determine whether thrombocytopenia is the cause.

How is thrombocytopenia diagnosed?

Thrombocytopenia shares symptoms with other medical conditions, such as anemia and hemophilia, making it harder to diagnose based on symptoms alone. Your health care provider may order blood tests to find the cause.

Here are some tests your provider may do:

• Blood tests: A complete blood count (CBC) can show if your platelet count is low. A blood smear is done to check the shape and appearance of your platelets. Other blood tests look for clotting proteins, infections, autoimmune disorders and vitamin deficiencies.
• Bone marrow tests: Sometimes, your provider may take a small sample of your bone marrow to see if it’s producing enough platelets. 

Your provider may suggest other tests and procedures to determine the cause of your condition.

Treatment options

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.

Common treatment options include:

• Medications: If you have an autoimmune condition like ITP, your provider may prescribe drugs to suppress your immune system and stop it from attacking platelets. Steroids or immunoglobins are often used in these cases.
• Blood or platelet transfusions: If your platelet count is very low or you’re experiencing severe bleeding, a transfusion can help boost your platelet levels quickly. This is often used in emergencies. 
• Plasma exchange (plasmapheresis): This treatment is often used when bleeding is caused by thrombotic thrombocytopenic purpura (TTP), a rare, life-threatening type of thrombocytopenia. It removes harmful substances from the blood and replaces them with healthy plasma.
• Immunoglobin therapy: IV immunoglobulin (IVIG) can help raise platelet counts for immune-related thrombocytopenia.
• Treating underlying causes: If an infection or another condition is causing your thrombocytopenia, treating that condition may improve your platelet count.
• Surgery: If other treatments don’t help, your provider may recommend surgery to remove your spleen (splenectomy). This is performed when your spleen is trapping a large number of platelets.

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.