Severe thrombocytopenia can be very dangerous, even fatal, without treatment. Treatment depends on the underlying cause but can include medications, transfusions, and surgery.

Severe thrombocytopenia is a condition caused by a very low blood platelet count. Platelets are the cells that stop both internal and external bleeding by helping your blood clot.

Thrombocytopenia can be mild, moderate, or severe.

Severe thrombocytopenia is a serious medical condition. It can cause significant symptoms, such as blood in your urine and stool, easy bruising, and excessive bleeding when you have a cut. It can also lead to dangerous internal bleeding, including brain bleeds, which can be fatal.

This article takes a closer look at severe thrombocytopenia, including potential causes, symptoms, and treatment.

How is severe thrombocytopenia defined?

The normal platelet count range for generally healthy adults is 150,000–450,000 platelets per microliter of blood. Anyone whose lab results show a reading below 150,000 platelets per microliter has thrombocytopenia.

Thrombocytopenia is not generally considered severe until a person’s platelet count per microliter of blood falls below 50,000.

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Severe thrombocytopenia can happen for a few reasons. Sometimes, it happens when platelets become trapped in your spleen and cannot get into your bloodstream.

It can also happen if your bone marrow stops making enough new and healthy platelets or if your immune system attacks the platelets your body makes.

In most cases, severe thrombocytopenia has underlying causes. Common causes include:

Is severe thrombocytopenia life threatening?

Severe thrombocytopenia can be life threatening without treatment. It can lead to excessive and serious bleeding both inside and outside your body. This includes bleeding in your brain, which can be fatal. However, this complication is rare. Treatment to resolve severe thrombocytopenia can help eliminate this risk.

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Symptoms of severe thrombocytopenia can include:

The exact treatment for severe thrombocytopenia depends on the underlying cause. Sometimes, treating the cause might be enough to completely resolve even severe thrombocytopenia.

This is especially true when the underlying cause is a medical treatment such as chemotherapy. Adjusting the dosage of a treatment or changing to a different medication, along with careful monitoring while platelet levels are restored, is often all that is needed.

However, in many cases, treatment is necessary for severe thrombocytopenia. When it is, options include:

  • Corticosteroid medications: Corticosteroid medications can help your body make more platelets.
  • Immunosuppressant medications: Immunosuppressant medications can help treat severe thrombocytopenia if your immune system is destroying your platelets.
  • Blood and platelet transfusions: Blood and platelet transfusions can replace your blood with blood that has healthy levels of platelets. Transfusions can be a good short-term treatment for severe thrombocytopenia.
  • Surgery: Sometimes, surgical spleen removal is an option for people with severe thrombocytopenia.
  • Therapeutic plasma exchange: Therapeutic plasma exchange, or plasmapheresis, is a treatment similar to kidney dialysis. It removes your blood from your body, separates your red and white blood cells from your plasma, and returns your blood to your body with replacement plasma.

Although the exact outlook for someone with severe thrombocytopenia depends on the underlying cause, the condition is typically very treatable. While severe thrombocytopenia can be very serious and even fatal, most people respond well to treatment.

For many people, severe thrombocytopenia is a side effect of medication, a complication of treatment, or a complication of another medical condition. In these cases, it’s often temporary.

However, if severe thrombocytopenia is chronic (long-term), healthcare professionals need to continually monitor and treat it. If you have chronic thrombocytopenia, your doctor will advise you on how to stay safe and avoid injuries that could put you in danger.

How long can someone live with severe thrombocytopenia?

Even when severe thrombocytopenia is chronic, it’s unlikely to affect your life span. The underlying condition that’s causing severe thrombocytopenia might affect your life span, but the thrombocytopenia itself should not.

Severe thrombocytopenia does increase the risk of death during events such as surgery, labor and delivery, and injuries, but if you do not experience these events, you will not have this risk.

Additionally, medical teams take precautions when they know that someone who is having surgery or going through labor has severe thrombocytopenia.

Severe thrombocytopenia happens when your level of blood platelets is very low. This means your blood cannot clot and your body has trouble stopping both internal and external bleeding.

This condition can be very dangerous. Without treatment, it can lead to bleeding in your brain, which can be fatal.

Symptoms of severe thrombocytopenia include easy bleeding and bruising and blood in stools, urine, and vomit.

Treatment depends on the underlying cause of severe thrombocytopenia but can include medications, blood transfusions, and surgery.