Thrombocytopenia is a health disorder where a person has a low platelet count. Platelets (or thrombocytes) are colorless blood cells responsible for blood clotting. They help prevent bleeding during an injury by clumping and forming plugs in the blood vessels. When someone has low platelets, they risk bleeding excessively when injured. It can happen to both children and adults. This post briefly discusses the common signs, causes, and ways to manage a low platelet count.

Normal platelet levels
Typically, a healthy platelet count in adults ranges between 150,000 and 450,000 platelets per microliter of blood. There are three thrombocytopenia levels:

• Severe: The platelet count ranges between 21,000 and 51,000 per microliter of blood.
• Moderate: The count ranges between 51,000 and per 100,000 microliter of blood.
• Mild: The count lies between 101,000 and 140,000 per microliter of blood.

Signs and symptoms
Most people with mild thrombocytopenia do not show any symptoms. However, when they do, the first sign is usually a nosebleed or cut, which does not stop bleeding. Other thrombocytopenia symptoms are as follows:

• Bleeding gums
  One’s gums may swell, and they may find blood on the gums or toothbrush.
• Blood in the urine
  Patients may notice blood in their urine. Consequently, the toilet water might look pink after peeing.
• Blood in the stool
  One’s stool might look unusually dark—a potential indicator of blood.
• Petechiae
  Low platelets sometimes lead to the formation of purple or red dots on the lower legs. It may look like a rash.
• Blood in the vomit
  Also called hematemesis, blood in the vomit is often a symptom of bleeding in the upper gastrointestinal tract.
• Rectal bleeding
  One might spot blood in the toilet water or see blood stains on the toilet paper after wiping.
• Bruises
  Bruises appear when the blood collects underneath the skin. People with low platelet counts may develop bruises more frequently.
• Heavy menstrual periods
  Women may suffer from menorrhagia (bleeding more than usual) or the periods might last longer than seven days.
• Purpura
  When the small blood vessels underneath the skin leak blood, it may result in purple, red, or brown spots.

This condition may be mild, triggering a few symptoms. However, in rare circumstances, the platelet count may drop dangerously, resulting in internal bleeding.

Causes and risk factors
Broadly, thrombocytopenia results from either of the following:

• Inadequate platelet production
  It occurs when the bone marrow does not generate enough platelets. The situation is common in those with lymphoma or leukemia.
• Platelet utilization or depletion
  Sometimes, the bone marrow produces adequate platelets, but underlying conditions cause rapid platelet destruction or consumption.
• Platelet sequestration in the spleen
  In this condition, the spleen captures the platelets, blocking their circulation into the bloodstream. Ideally, the spleen stores approximately 33% of the total platelet supply.

A few other factors that can affect platelet supply are:

• Blood cancers
  Lymphoma and leukemia might damage the bone marrow and hamper its ability to make adequate blood cells or platelets.
• Autoimmune diseases
  Autoimmune conditions like lupus, rheumatoid arthritis, or immune thrombocytopenia (ITP) may attack the immune system, destroying the platelets.
• Infections
  Viral or bacterial infections might decrease one’s platelet count.
• Cancer treatments
  Treatments like radiation therapy and chemotherapy may destroy the stem cells that develop into platelets.
• Toxic chemicals
  Pesticide, benzene, and arsenic exposure may hamper one’s platelet levels.

Thrombotic thrombocytopenic purpura (TPP) is a blood disorder responsible for blood clots in the small vessels across the body. Platelets help in blood clotting. When one has TPP or disseminated intravascular coagulation, a similar condition, the platelet supply may decline as these consume the platelets.

Treatment options
Several treatment options can cure low platelet count. Doctors suggest a suitable approach based on the disease’s severity and the underlying causes. Treatment is especially the protocol for severe cases. Mild cases might only need active monitoring. Some prevalent treatment options are as follows:

• Platelet or blood transfusions
• Changing ongoing treatments responsible for low platelet count
• Surgery for spleen removal
• Prescribing treatments that can suppress the immune system function

Managing low platelets
Those with a low platelet count can take the following measures to reduce their bleeding susceptibility:

• Inquire about the risk of bleeding.
• Use an electric razor for shaving to reduce chances of cuts and nicks.
• Avoid contact sports.
• Gently blow the nose to avoid risks of nosebleeds.
• Use an extra-soft toothbrush, as inflamed gums bleed more easily when flossing.
• Do not floss when the platelet count is severely low.
• Be cautious when working with sharp objects like scissors or knives.