Thrombocytopenia, Blood platelet deficiency in rheumatic disease 4.25/5 (12)

Last updated: 13 / 12 / 20
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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

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

 

Increased destruction of platelets

  • 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

Bone marrow examination

Treatment

  • Treatment of thrombocytopenia is dependent on the cause and must be assessed in each case

Literature

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