Thrombocytopenia (low blood platelet count): ICD-10: D69.6

Petechiae (small, dot-shaped bleeding) in the skin of the calf and foot by the low number of platelets (thrombocytopenia). Manasal R, Indian J Pharmacol (2013). CC BY NC SA 3.0
Contents
Definition
Normally, the number of platelets (platelets) is measured in blood samples between 150.000-450.000 x 109/ L. thrombocytopenia:
- Platelet count below 100.000 x 109/L
- Severe thrombocytopenia: 1-20.000 x 109/L
- Moderate: 10 - 30.000 x 109/L
- Mild: 30 - 50.000 x 109/L
Causes
Cause of thrombocytopenia is divided into either reduced production or increased platelet destruction
-
Reduced production of platelets (in the bone marrow)
- Leukemia and other Diseases of the bone marrow
- Some types of anemia (Low hemoglobin)
- Viral infections (including Hepatitis C or HIV)
- Chemotherapy and other drugs (see below)
- Large alcohol consumption
- hypothyroidism (low metabolism)
Increased destruction of platelets
- Autoimmune diseases (SLE, Antifosfolipid syndrome, Rheumatoid arthritis (possibly with Felty's syndrome), Still illness in adulthood
- Sepsis (bacteria)
- Thrombotic Thrombocytopenic purpura
- Immune thrombocytopenia (ITP)
- Pregnancy
-
Medication
- Cytotoxic drugs
- Heparin
- Sulpha-preparations
- Epilepsy drugs
- Hydroxychloroquine /Plaquenil (Very rare)
Symptoms
- Increased bleeding tendency (most often when the number of platelets is lower than 50.000)
- Superficial small red bleeding, most often on the lower legs
- Prolonged bleeding after small injuries
- Bleeding from the mucous membranes and gums
- Unusually strong menstrual bleeding
- Potentially life-threatening bleeding if the number of platelets is below 10.000 / micro liters
Diagnosis
Clinical examination
- Look for bleeding under the skin, the mucous membranes and in joints. Examine the abdomen and the spleen size
Blood tests
- Complete cell count with red and white blood cells with differential counts and platelets in citrate blood (prevents aggregates and error measurement)
- Blood smears (schistocytes and abnormal platelets)
- ANA (Autoimmune disease)
- Haptoglobin (hemolysis)
- TSH (hypothyroidism)
- HIV, Hepatitis C, antiphospholipid antibodies
Bone marrow examination
Treatment
- Treatment of thrombocytopenia is dependent on the cause and must be assessed in each case
Literature
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