Thrombocytopenia

Thrombocytopenia means you have fewer platelets in your blood than normal. Platelets help your blood clot and stop bleeding. When platelet levels are low, you may bruise easily or bleed longer than usual.

In many people, thrombocytopenia is mild and causes no major problems. In others, it can lead to serious bleeding and needs quick medical care.

The right treatment depends on the cause and the extent of the low platelet count.

Key Facts

Usually seen in

All age groups (cause differs by age and health condition)

Main body system involved

Blood and bone marrow (platelets are made in the bone marrow)

Why it matters

Low platelets can increase the risk of bleeding, especially when counts are very low.

Common Symptoms

Some people have no symptoms and find it during routine blood tests. When symptoms occur, they may include:

Mild to moderate signs

• Easy bruising
• Small red or purple spots on the skin (petechiae), often on the legs
• Bleeding from the gums or the nose
• Heavier menstrual bleeding
• Bleeding that takes longer to stop after small cuts

Severe warning signs

• Blood in urine or stool
• Vomiting blood or black stools
• Severe headache, confusion, or vision changes
• Unusual heavy bleeding or bleeding that will not stop

Causes of Thrombocytopenia

Low platelet counts can occur for several reasons. Common cause groups include:

1) Reduced platelet production

• Viral infections
• Vitamin B12 or folate deficiency
• Bone marrow disorders (less common)
• Some medicines that affect bone marrow

2) Increased platelet destruction

• Immune thrombocytopenia (ITP)
• Infections such as dengue (common in some regions)
• Certain medicines (drug-induced thrombocytopenia)
• Autoimmune conditions

3) Platelet trapping in the spleen

• An enlarged spleen can hold more platelets and reduce platelets in circulation

4) Dilution or consumption (hospital settings)

• Major bleeding, severe infection, or other serious illnesses can reduce platelets quickly

Diagnosis

Doctors confirm thrombocytopenia with a blood test, then investigate the cause.

Tests commonly advised

• Complete Blood Count (CBC) with platelet count
• Peripheral blood smear (to check platelet size and other blood cells)
• Liver and kidney function tests (as needed)
• Viral tests if infection is suspected (based on symptoms)
• Vitamin B12 and folate levels (if deficiency suspected)
• Additional tests based on history and exam

Treatment and Care

Treatment depends on how low the platelets are, symptoms, and the cause.

If mild and no bleeding

• Monitoring with repeated platelet counts
• Treating the underlying cause (example: correcting deficiencies, managing infection)

If immune-related (like ITP)

• Medicines to reduce immune destruction (doctor decides based on severity)

If medicine-related

• Stopping or changing the suspected medicine under medical guidance

If severe or active bleeding

• Hospital care may be needed
• Platelet transfusion may be considered in certain situations
• Treatment for the underlying emergency cause

Safety Tips

Things that can reduce bleeding risk

• Avoid alcohol if it worsens platelet issues
• Avoid activities with high injury risk if platelets are low
• Ask a doctor before using medicines that can increase bleeding (some painkillers and blood thinners)

When to Seek Urgent Medical Help

Get medical help immediately if you have:

• Heavy bleeding that does not stop
• Blood in vomit, urine, or stool
• Black stools
• Severe headache, confusion, fainting, or vision changes
• Very large bruises without injury

Specialists to Consult

• Hematologist (blood specialist)
• Physician / Internal medicine doctor (initial evaluation and monitoring)