Thrombocytopenia-Introduction
Hematological disease characterized by having an increased chance of developing bleeding disorders and having decreased platelet counts is known as thrombocytopenic. Thrombocytes are essential in forming platelets for blood clotting. Therefore, if a person has thrombocytopenia, they will have an increased chance of experiencing spontaneous or prolonged bleeding. Thrombocytopenia is one of the most prevalent congenital and acquired coagulation disorders in critically ill patients. The severity of this disorder may range in severity from asymptomatic to life-threatening.
Normal Platelet Range and severity
Normal Range:150,000 – 450,000
<50,000/μL:Incresead Bleeding risk
<30,000/ μL : Spontaneous bruising possible
<10,000/ μL : High risk of serious spontaneous bleeding
Signs and Symptoms
Petechiae
Purpura and ecchymosis
Nosebleeds or bleeding gums
Heavy menstrual bleeding
Fatigue and Weakness
Severe cases : Continuous Bleeding or blood filled oral blisters
Causes of Thrombocytopenia
1)Decreased Platelet Production
Vitamin B12 or folate deficiency
Bone marrow disorders
Liver Failure
Sepsis and systemic infections
2)Increased Platelet Destruction
Immune thrombocytopenic purpura (ITP)
Thrombotic thrombocytopenic purpura (TTP)
Disseminated intravascular coagulation (DIC)
Hemolytic–uremic syndrome (HUS)
Systemic lupus erythematosus (SLE)
Diagnosis
Assessment will consist of:
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Complete Blood Count (CBC)
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Peripheral Blood Smear
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Liver Function Tests
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Kidney Function Test
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Vitamin B12 & Folate Levels
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Bone Marrow Biopsy if cause is uncertain
Diagnosis is based on whether it is due to decreased production or increased destruction.
Treatment:
The treatment for thrombocytopenia depends on the severity of the thrombocytopenia as well as the underlying cause.
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Mild cases may just need observation
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ITP (Idiopathic thrombocytic purpura) may require corticosteroids
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In severe bleeding, platelet transfusions may be appropriate
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TTP (Thrombocytopenic thrombotic purpura) is considered a medical emergency and may require plasmapheresis
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In cases of HIT (Heparin induced thrombocytopenia), the drugs causing this should be discontinued
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In extreme congenital cases, it may be necessary to perform a bone marrow transplant
In cases of neonatal (newborn) thrombocytopenia, the treatment will be directed at treating the infection or immune issue responsible for the thrombocytopenia.
Conclusion
Thrombocytopenia is a prevalent yet serious health problem because it can lead to low platelets and high chances of bleeding (i.e. bleeding more easily). There are many reasons for thrombocytopenia including: Seasoned nutrition; Infections; Immune system disorders; Bone marrow diseases. It is important to identify the cause early; whether due to a lack of production or by high numbers of destruction to find the correct treatment. Finding thrombocytopenia early with the right medical evaluation can potentially save complications and have better outcomes for the patients.
MBH/PS