Blood Clotting Disorder Hypercoagulation Thrombotic Thrombocytopenic Purpura

Thrombocytopenia is a condition in which the blood doesn’t have enough platelets. Platelets, also called thrombocytes, are blood cells that assist in the formation of blood clots. The ability to properly form blood clots is essential to reducing the amount of blood that a person loses after experiencing trauma or injury. Thus, a person with thrombocytopenia can experience excessive bleeding even after a minor injury.

Thrombocytopenia Causes

Thrombocytopenia can be caused by a number of factors, including illness and certain medications. Causes of thrombocytopenia include the following, among others:

  • anemia
  • blood transfusions
  • drugs, including heparin, quinine and rifampin
  • leukemia
  • lymphoma
  • heavy alcohol consumption
  • HIV.

Disorders that cause a person’s body to destroy or use an excess of platelets can also cause thrombocytopenia. These disorders include idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome:

Hemolytic-Uremic Syndrome: Hemolytic-uremic syndrome (HUS) is a disorder characterized by a sudden decrease in a person’s platelet count and the destruction of red blood cells. In addition, a person with HUS experiences kidney failure.

HUS is most common in infants, children and women who are pregnant or who have recently given birth. The condition can be caused by bacterial infections.

Idiopathic Thrombocytopenic Purpura: This disease is characterized by the destruction of platelets by antibodies. Researchers do not know what causes the antibodies that destroy the platelets to form in a person’s blood.

Thrombotic Thrombocytopenic Purpura: Thrombotic thrombocytopenic purpura (TTP) is a serious blood disease that causes blood clots to form suddenly throughout the blood vessels in the body.

Depending on where the clots form, TTP symptoms can include:

  • abdominal pain
  • abnormal heart beat
  • bloody urine
  • coma
  • confusion
  • headache
  • seizure.

Thrombocytopenia Symptoms

Often, the first sign of thrombocytopenia is bleeding in the skin that may appear as tiny red dots (petechiae). Most often, this bleeding is seen on the legs. Also, people with low platelet counts might bruise easily after minor injuries. In addition, people suffering from thrombocytopenia may experience:

  • bleeding gums
  • bloody stools and/or urine
  • excessive bleeding that is difficult to stop
  • heavy menstrual periods.

In people with thrombocytopenia, the bleeding will get worse as the number of platelets in the blood decreases. As the platelet count falls, people may experience heavy bleeding in the digestive tract or may have heavy, life-threatening bleeding in the brain.

Also, it is important to note that TTP and HUS symptoms are different from those of most other forms of thrombocytopenia.

Thrombocytopenia Diagnosis and Treatment

If your doctor thinks you are suffering from thrombocytopenia, he can check for the condition by testing your bone marrow or by performing a blood platelet count.

People who have very low numbers of platelets are often put on bed rest to reduce the risk of injury and bleeding. If, however, a person is experiencing severe bleeding, he may require a platelet transfusion.

In people who are experiencing low platelet counts as a result of medication, the doctor will likely ask the patient to stop taking the medicine. If, however, antibodies are causing the low platelet count, a corticosteroid, such as prednisone, may be prescribed to prevent the antibodies from forming.

Adults who have ITP will likely require a splenectomy, a procedure in which the spleen is surgically removed, to increase the platelet count.

TTP is often treated by plasma exchanges, which are plasma transfusions combined with plasmpheresis. Plasmpheresis is a process in which the substances that might be harmful to the body are removed from the blood. Treatments can last for a week or more and take about three hours per day.

Resources

Moake, Joel L. (2006). Thrombocytopenia (ITP, TTP) Retrieved September 23, 2007, from the Merck Manuals Online Medical Library site: http://www.merck.com/mmhe/sec14/ch173/ch173d.html.

Mayo Clinic Staff (2006). Thrombocytopenia (Low Platelet Count). Retrieved September 23, 2007, from the Mayo Clinic Web site: http://www.mayoclinic.com/health/thrombocytopenia/DS00691/DSECTION=3.