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Thrombocytopenia - Know More About It

Written and reviewed by
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Internal Medicine, FRCP (UK), FRCPath -Haematology
Hematologist, Mumbai  •  37 years experience
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Hello,

This is Dr Savita Rangarajan. We are going to talk about thrombocytopenia today, so what is thrombocytopenia? In fact, first of all, I need to explain to you what is a platelet? In blood we have three kinds of cells, red cells, white cells and platelets. Platelets are very important for us to prevent bleeding, they go to the site of injury immediately after an injury and plug the gap that is there and prevent it from bleeding, therefore, platelets are the primary preventer of any bleeding event, so if our platelet number goes down or what is called thrombocytopenia there is a potential to bleed.

So the multiple reasons why one can have thrombocytopenia? In our body, the platelet count normally is between 150,000 to 400,000 and anything below a hundred and fifty thousand is actually called thrombocytopenia. We don't actually get into any trouble in terms of bleeding unless the platelet count drops significantly and only if it falls below 20,000 that we will get spontaneous bleeding or very easy bruising, in fact, we can actually undergo even surgery if a platelet count is above hundred thousand. So the body itself or nature has given us quite a good leeway in terms of platelet count; however, having a low platelet count may actually also predict some other conditions that may require treatment itself.

So apart from that having a low platelet count means that it is better to get investigated for the reason of a low platelet count and as the platelet count may drop further it is important that one diagnosis the reason for it and appropriate treatment instituted accordingly. As I said once the platelet count is significantly low, then there are bleeding symptoms so the bleeding symptoms can be quite dangerous and therefore especially you can have bruising as I said small pinpoint bleeds into the skin called petechiae or bleed into the gums and there could be blood blisters in the mouth. It is typically seen in something called immune thrombocytopenia or ITP, so therefore I'll come now to the causes of different thrombocytopenia.

So one of the main reasons of low platelet count is immune thrombocytopenia or an antibody-mediated low platelet count and of course, there are other reasons as well which I'll come to in a bit, but I think immune thrombocytopenia is a major cause for low platelet. Of course, the various ways of modalities of treating ITP include immune suppression by various methods and potentially one can also treat if necessary if it is refractory by splenectomy.

However, the more important reasons for low platelet count is actually low production by the marrow itself and that too could be other conditions like mild dysplasia or where the marrow itself is not functional enough, there are inherited causes as well where platelets can be low because the marrow is not able to produce enough platelets. Of course infection in our country is very important and we know that dengue can cause low platelet count, so there are multiple reasons for low platelet count and I think it is extremely important if one knows that the platelet count is low and you need to go to a proper hematologist in order to get yourself properly diagnosed and treated and also importantly I think as I've already mentioned low platelet count can be found by routine blood count very easily and it may be that you may not have any symptoms related to it, however, it is important to find out the root cause of the low platelets.

I think I have briefly explained about low platelets and I think it is important for you to go to the lybrate website if you want to know more about this and also to contact the right doctors about it as well. I'm sure you'll find some more videos relating to this topic on lybrate.

Thank you

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