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Hematology focuses on diseases of the blood, bone marrow, and lymphatic system. Learn about the diagnosis and treatment of anemia, leukemia, and lymphoma.
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The treatment of thrombocytopenia is highly individualized. It depends entirely on the cause of the low count and the severity of the bleeding risk. Not every patient with a low count needs medication; many are simply monitored. However, when counts drop to dangerous levels or bleeding occurs, rapid intervention is required. At Liv Hospital, our treatment hierarchy ranges from observation to advanced immunotherapy and surgical options, always prioritizing the patient’s safety and long term quality of life.
For patients with mild thrombocytopenia (counts above 30,000 to 50,000) who have no active bleeding, treatment is often unnecessary.
The strategy involves regular blood checks to ensure the count is stable.
Patients are advised to avoid activities that could cause injury and to stay away from blood thinning medications like aspirin or ibuprofen. The body often corrects the balance on its own, especially in cases following a viral infection.
For immune causes like ITP, steroids are the standard initial treatment.
Drugs like prednisone or dexamethasone work by suppressing the immune system. They slow down the antibody production and reduce the destruction of platelets by the spleen.
This is usually a short term measure to boost counts rapidly. Long term use is avoided due to side effects like weight gain, high blood sugar, and bone loss.
When a rapid increase in platelets is needed, such as before urgent surgery or during severe bleeding, IVIG is used.
This infusion floods the body with healthy antibodies. These “distract” the spleen’s destruction mechanism, allowing the patient’s own platelets to survive longer.
The rise in platelets is quick (within 24 to 48 hours) but temporary, usually lasting only a couple of weeks.
For chronic ITP or liver disease related low platelets, doctors may use drugs that mimic the body’s natural growth signal.
Medications like Eltrombopag (pill) or Romiplostim (injection) bind to the bone marrow cells and tell them to produce more platelets.
These are maintenance drugs used to keep the count in a safe range, not necessarily a normal range, to prevent bleeding.
This is a monoclonal antibody used if steroids fail.
It targets B cells, the part of the immune system that makes the antibodies attacking the platelets. By eliminating these cells, the autoimmune attack is halted.
The response can take weeks to appear but can lead to remission lasting a year or more.
Since the spleen is the primary site where platelets are destroyed in autoimmune disease, removing it can cure the condition.
This is considered for patients with chronic severe ITP who do not respond to medications.
It provides a permanent remission in about two thirds of patients. However, removing the spleen increases the lifelong risk of certain bacterial infections, requiring permanent vaccination protocols.
Transfusions are reserved for emergencies or when production is halted (like during chemotherapy).
In autoimmune conditions, transfused platelets are destroyed just as quickly as the patient’s own, so they provide very little benefit unless the immune attack is also suppressed.
They are standard care for chemotherapy patients whose counts drop below 10,000 or who are actively bleeding.
If a medication is identified as the cause, stopping it is the primary treatment.
Counts usually begin to recover within days of stopping the drug.
In the case of Heparin Induced Thrombocytopenia (HIT), simply stopping heparin is not enough; an alternative non heparin blood thinner must be started immediately to prevent clots.
If HIV or Hepatitis C is the driver, treating the virus with antiviral medications often leads to a rise in platelet counts as the viral load decreases and the marrow recovers.
Send us all your questions or requests, and our expert team will assist you.
Usually only if your count is extremely low (under 10,000) or if you are actively bleeding. In autoimmune cases, transfusions are less effective.
Short term effects include energy, trouble sleeping, and appetite increase. Long term use can cause weight gain, face swelling, high blood pressure, and bone weakness.
It depends on the cause. Drug induced and viral types are often curable. Chronic autoimmune ITP is manageable but may be a lifelong condition.
Yes, the spleen filters bacteria from the blood. Without it, you are at higher risk for severe infections and will need special vaccines.
Drugs like Eltrombopag usually take 1 to 2 weeks to start raising the platelet count. They are not for instant emergency use.
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