Thrombocytopenia

In our blood, platelets (or thrombocytes) have a vital role in the body's hemostasis (stopping of bleeding). They are made of tiny cell fragments with a lifespan of 5-9 days, constituting the most number of cells in the blood. Their primary function takes part in the clotting process, attempting to stop the bleeding from a wound. With the help of other substances in the body, such as fibrinogen, Calcium and Vitamin K, they form together into a clot.

However, there are instances that the platelet (thrombocyte) level becomes too low making it impossible to perform its function. Thrombocytopenia is the term used to denote for low or decreased platelet level putting a person at increased risk of spontaneous bleeding.

Symptoms
The risk of spontaneous bleeding manifests in the form of purpura (pin-point purplish spots in the skin), ecchymoses (bruises), and epistaxis (nose bleed).

Other common symptoms are dark colored urine indicating blood in the urine, abnormally prolonged and heavy menstruation, dark, tarry stools, and coffee-ground-like vomitus indicating gastrointestinal (GI) bleeding.

Causes and Treatments
• Thrombotic Thrombocytopenic Purpura (TTP) -
A rare blood condition called Thrombotic Thrombocytopenic Purpura causes thrombocytopenia because in this condition, there is constant formation of small clots or thrombi in the circulation, consuming the platelets in the blood. Common causes are infection, pregnancy, drugs, systemic lupus erythematosus (SLE), and malignancy.

• Idiopathic Thrombocytopenic Purpura (ITP) -
According to Dr. Claire Harrison, consultant haematoligist at St. Thomas' Hospital in London, and Professor Samuel Machin of University College London Hospital, another condition that causes thrombocytopenia is Idiopathic Thrombocytopenic Purpura, but this time it is of unknown origin as term idiopathic suggests. In this condition, the body's antibodies coat the surfaces of the platelets, destroying them and causing their level to drop.

It can either be acute where it suddenly appears following a viral illness in a child. Acute ITP usually doesn't need treatment. The other type is chronic ITP, more common in adults, long lasting, and developing over time. Common treatments for this condition are steroids (usuall prednisone), immunoglobulin, and anti-D antibody.

In cases that the extent is severe, splenectomy is done. Removing the spleen, which is the primary site for platelet destruction for most patients with ITP, is an option for chronic ITP if platelet count remains too low and the person isn't responding well to treatments.

Other Causes
Other causes of thrombocytopenia could be either a secondary result of a condition such as Dengue Hemorrhagic Fever, or it could be drug-induced such as too much unsupervised intake of aspirin or heparin use.

 


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