Blood is made up of several types of cells. These cells float in a liquid called plasma. The types of blood cells are:
- red blood cells
- white blood cells
- platelets, or thrombocytes
When your skin is injured or broken, platelets clump together and form clots to stop the bleeding. When you don’t have enough platelets in your blood, your body cannot form clots.
A low platelet count may also be called thrombocytopenia. This condition can range from mild to severe, depending on its underlying cause. For some, the symptoms can include severe bleeding and are possibly fatal if they’re not treated. Other people may not experience any symptoms.
Typically, a low platelet count is the result of a medical condition, like leukemia, or certain drugs. The treatment usually addresses the condition causing the thrombocytopenia.
Whether or not you experience symptoms of a low platelet count depends on your platelet count.
Mild cases, such as when a low platelet count is caused by pregnancy, usually don’t cause any symptoms. More severe cases may cause uncontrollable bleeding, which requires immediate medical attention.
If you have a low platelet count, you may experience:
- red, purple, or brown bruises, which are called “purpura”
- a rash with small red or purple dots called “petechiae”
- bleeding gums
- bleeding from wounds that lasts for a prolonged period or doesn’t stop on its own
- heavy menstrual bleeding
- bleeding from the rectum
- blood in the stools
- blood in the urine
In more serious cases, you may bleed internally. The symptoms of internal bleeding include:
- blood in the urine
- blood in the stool
- bloody or very dark vomit
Talk to your doctor immediately if you experience any signs of internal bleeding.
Rarely, this condition may lead to bleeding in your brain. If you have a low platelet count and experience headaches or any neurological problems, tell your doctor right away.
The possible causes of a low platelet count include:
Bone Marrow Problems
Your bone marrow is the spongy tissue inside the bone. It’s where all the components of blood, including platelets, are produced. If your bone marrow isn’t producing enough platelets, you’ll have a low platelet count. The causes of low platelet production include:
- aplastic anemia
- a vitamin B-12 deficiency
- a folate deficiency
- an iron deficiency
- viral infections, including HIV, Epstein-Barr virus, and chickenpox
- exposure to chemotherapy, radiation, or toxic chemicals
- consuming too much alcohol
Each platelet lives about 10 days in a healthy body. A low platelet count can also be a result of the body destroying too may platelets. This can be due to side effects of certain medications, include diuretics and anti-seizure medications. It can also be a symptom of:
- hypersplenism, or an enlarged spleen
- an autoimmune disorder
- a bacterial infection in the blood
- idiopathic thrombocytopenic purpura (ITP)
- thrombotic thrombocytopenic purpura (TTP)
- hemolytic uremic syndrome
- disseminated intravascular coagulation (DIC)
If your doctor suspects a low platelet count, they’ll first perform a physical examination. During the exam, your doctor will check your body for any unusual bruising or evidence of petechiae, which is a rash that often accompanies a low platelet count.
Your doctor may also feel your abdomen to check for an enlarged spleen, which can cause a low platelet count. You may also be asked if you have any family history of bleeding disorders since these types of disorders can run in families.
To diagnose this condition, your doctor needs to do a complete blood count (CBC) test. This blood test looks at the amount of blood cells in your blood. It will tell your doctor if your platelet count is lower than it should be.
Your doctor may also wish to have your blood tested for platelet antibodies. These are proteins that your body produces and that destroy platelets. Platelet antibodies can be produced as a side effect to certain drugs, such as clopidogrel (Plavix), or for unknown reasons.
Your doctor may also order blood-clotting tests, which includes partial thromboplastin time (PTT) and prothrombin time (PT). These tests simply require a sample of your blood. Certain chemicals will be added to the sample to determine how long it takes your blood to clot.
If your doctor suspects that your spleen is enlarged, they may order an ultrasound. This test will use sound waves to make a picture of your spleen. It can help your doctor determine if your spleen is the proper size.
Bone Marrow Aspiration and Biopsy
If your doctor suspects that a problem in your bone marrow is causing your low platelet count, they may order a bone marrow aspiration. During an aspiration, your doctor will use a needle to remove a small amount of bone marrow from one of your bones.
A bone marrow biopsy may also be ordered. Your doctor will use a needle to take a sample of your core bone marrow, usually from the hipbone. It may be performed at the same time as a bone marrow aspiration.
The treatment for a low platelet count depends on the cause and severity of your condition. If your condition is mild, your doctor may wish to hold off on treatment and simply monitor you.
Your doctor may recommend that you take measures to prevent your condition from worsening. This could include:
- avoiding contact sports
- avoiding activities with a high risk of bleeding or bruising
- limiting alcohol consumption
- stopping or switching medications that affect platelets, including aspirin and ibuprofen
If your low platelet count is more severe, you may need medical treatment. This may include:
- blood or platelet transfusions
- changing medications that are causing a low platelet count
- immune globulin
- corticosteroids to block platelet antibodies
- drugs that suppress your immune system
- a splenectomy, or the surgical removal of the spleen
Not everyone with a low platelet count needs treatment. Some conditions that cause a low platelet count will eventually clear up. The platelet count will return to healthy levels in those cases.
However, people with severe cases may need treatment. Sometimes, a low platelet count can be fixed by treating the underlying cause. Your doctor will work with you to come up with a treatment plan that helps you manage your symptoms.