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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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Thrombocytopenia is a hematological disorder defined by a lower than normal number of platelets in the blood. Platelets, also known as thrombocytes, are small, colorless cell fragments produced in the bone marrow that play a fundamental role in the body’s ability to stop bleeding. When a blood vessel is injured, platelets rush to the site and form a plug to seal the hole, a process called hemostasis. In a healthy individual, the platelet count typically ranges from 150,000 to 450,000 platelets per microliter of blood. When this count drops below 150,000, the condition is medically termed thrombocytopenia. While mild cases may cause few or no signs, severe thrombocytopenia can lead to uncontrollable bleeding, either externally or internally. At Liv Hospital, we approach this condition as a disturbance in the delicate balance of blood cell production and survival, requiring a thorough investigation to identify the root physiological cause.
To understand thrombocytopenia, one must first understand how the body creates platelets.
Platelets are not complete cells; they are fragments of cytoplasm derived from very large bone marrow cells called megakaryocytes. A single megakaryocyte can fragment into thousands of platelets.
The production rate is controlled by a hormone called thrombopoietin, which is primarily produced by the liver. When the body detects low platelet levels, the liver releases more thrombopoietin to stimulate the bone marrow. In thrombocytopenia, this feedback loop may be disrupted, or the marrow may be unable to respond to the signal due to disease or suppression.
There are three main physiological reasons why a person might have low platelets.
This occurs when the bone marrow factory is shut down or crowded out. Conditions like leukemia, aplastic anemia, or deficiencies in Vitamin B12 and folate can stop the marrow from making enough megakaryocytes. Viral infections and heavy alcohol consumption also directly suppress marrow function.
In this scenario, the marrow is working correctly, but the platelets are being destroyed in the bloodstream faster than they can be replaced. This is often due to autoimmune diseases where the body’s antibodies attack the platelets, or non immune conditions where platelets are used up too quickly in abnormal clots.
Normally, about one third of the body’s platelets are held in the spleen. If the spleen becomes enlarged (splenomegaly) due to liver disease or cancer, it can trap up to 90 percent of the platelets, removing them from circulation and causing a drop in the blood count.
One of the most common forms of the disorder is Immune Thrombocytopenia, formerly known as Idiopathic Thrombocytopenic Purpura.
In ITP, the immune system mistakenly identifies platelets as foreign invaders. It produces antibodies that attach to the surface of the platelets.
As these antibody coated platelets circulate through the spleen, they are recognized by immune cells called macrophages and destroyed. This dramatically shortens the lifespan of the platelet from the normal 7 to 10 days to just a few hours.
Many medications can cause a temporary drop in platelet counts.
Drugs used to treat cancer act by killing rapidly dividing cells. Since bone marrow cells divide rapidly to make blood, they are often collateral damage, leading to a temporary halt in platelet production.
This is a rare but dangerous reaction to the blood thinner heparin. Paradoxically, instead of causing bleeding, the immune reaction activates platelets, causing them to clump together and form clots throughout the body, which consumes the available platelets and drops the count.
It is important to distinguish true disease from a false lab result.
Sometimes, platelets clump together when blood is drawn into a test tube containing a specific anticoagulant called EDTA.
Automated blood counters may misread these large clumps as white blood cells or simply miss them, reporting a falsely low platelet count. A review of the blood smear under a microscope usually clarifies this non dangerous condition.
Pregnancy can alter blood composition.
During pregnancy, the volume of blood plasma increases significantly, which can dilute the concentration of platelets.
Additionally, mild platelet destruction can occur near the end of pregnancy. This type of thrombocytopenia is usually mild, requires no treatment, and resolves shortly after delivery.
These are rare, life threatening conditions that cause low platelets.
In Thrombotic Thrombocytopenic Purpura (TTP) and Hemolytic Uremic Syndrome (HUS), tiny blood clots form spontaneously throughout the body’s small vessels.
These widespread clots consume platelets rapidly, leading to a severe drop in the circulating count, along with damage to red blood cells and organs like the kidneys and brain.
Send us all your questions or requests, and our expert team will assist you.
A healthy platelet count ranges from 150,000 to 450,000 platelets per microliter of blood.
No, it is not a cancer itself, but it can be a symptom of blood cancers like leukemia or lymphoma.
No, thrombocytopenia is not contagious. However, viral infections that cause it can be spread between people.
In a healthy body, a platelet lives for about 7 to 10 days before being removed by the spleen.
Not always. Many people with mild thrombocytopenia (counts between 100,000 and 150,000) have no symptoms and bleed normally.
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