Discovery of thrombocytopenia (reduced platelet count)
Definition of thrombocytopenia
Thrombocytopenia is also called reduced platelet count medically. Thrombocytopenia is such a situation that platelets are produced from the bone marrow slower than the speed they are lost.
Thrombocytopenia may be caused by
•   a failure of platelet production
•   an increased rate of removal from blood.
About platelets
Platelets are tiny cells that circulate in the blood and whose function is to take part in the clotting process.
Inside each platelet are many granules, containing compounds that enhance the ability of platelets to stick to each other and also to the surface of a damaged blood vessel wall.
The platelet count in the circulating blood is normally between 150 and 400 million per millilitre of blood. Newborn babies have a slightly lower level, but are normally within the adult range by three months of age.
Many factors can influence an individual's platelet count including exercise and racial origin. The average life span of a platelet in the blood is 10 days.
Danger that thrombocytopenia brings with
The main effect of a reduced platelet count is an increased risk of bleeding, but this rarely occurs until there are less than 80-100 million platelets per ml.
There is not a close relationship between the number of platelets and the severity of bleeding, but there is an increasing risk of haemorrhage if platelet numbers fall or if platelet function is impaired (for example by aspirin, which reduces the 'stickiness' of the platelets).
There is a particularly high risk of spontaneous bleeding once the platelet count drops below 10 million per ml. The bleeding is usually seen on the skin in the form of tiny pin-prick haemorrhages (purpura), or bruises (ecchymoses) following minor trauma.
Bleeding from the nose and the gums is also quite common. More serious haemorrhage can occur at the back of the eye (retina), sometimes threatening sight.
The most serious complication, which is potentially fatal, is spontaneous bleeding inside the head (intracranial) or from the lining of the gut (gastrointestinal).
Suggested treatment for thrombocytopenia
Treatment of thrombocytopenia varies according to the cause. If thrombocytopenia is drug-induced, then removal of the offending agents should correct the condition.
Corticosteroids may be used to increase platelet production. Lithium carbonate or folate may also be used to stimulate the bone marrow production of platelets. Platelet transfusions may be used to stop episodic abnormal bleeding caused by a low platelet count. However, if platelet destruction results from an immune disorder, platelet infusions may have only a minimal effect and may be reserved for life-threatening bleeding.
Splenectomy may be necessary to correct thrombocytopenia caused by platelet destruction. A splenectomy should significantly reduce platelet destruction because the spleen acts as the primary site of platelet removal and antibody production.
Patients with idiopathic thrombocytopenic purpura (ITP) may require high-dose intravenous immunoglobulin. Patients with thrombotic thrombocytopenic purpura (TTP) will probably require large-volume plasmapheresis (plasma exchange).
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