There are two main causes of a low platelet count

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1 Thrombocytopenia Thrombocytopenia is a condition in which a person's blood has an unusually low level of platelets Platelets, also called thrombocytes, are found in a person's blood along with red blood cells and white blood cells They stop bleeding by helping the blood to clot and plugging damaged blood vessels Thrombocytopenia happens when the body does not make enough platelets, is losing platelets, or destroys platelets, and sometimes associated with abnormal bleeding Thrombocytopenia is common in people with cancer, especially in those receiving chemotherapy A healthy person usually has a platelet count of 150,000 to 400,000. You have thrombocytopenia if your number falls under 150,000 Platelet function abnormalities (thrombocytopathy) include a range of inherited and acquired defects of platelet function. Thrombocytopathy may cause a thrombotic or a bleeding tendency or may be part of a wider disorder such as myelodysplasia

2 Signs and symptoms People with thrombocytopenia may experience some of these symptoms: Unexpected bruising Small purple or red spots under the skin, called petechiae Bleeding from the nose or gums Heavier than usual menstrual periods in women Black or bloody bowel movements or red- or pink-colored urine Bloody vomit Severe headaches Dizziness Pain in the joints or muscles Increased weakness Often, symptoms do not occur until the level of platelets is very low. Many patients do not know they have thrombocytopenia until it is diagnosed during a blood test

3 Causes Platelets and red and white blood cells are made in bone marrow, the soft, spongy tissue found inside larger bones Some types of chemotherapy and other medications damage the bone marrow, lowering its production of platelets. However, thrombocytopenia caused by chemotherapy is usually temporary In addition, a person's body can make specialized proteins called antibodies that cause a person s immune system to attack platelets Normally, antibodies help destroy substances that appear harmful to the body, such as bacteria and viruses, but sometimes this process works incorrectly and antibodies are produced that destroy healthy parts of a person s body Radiation therapy alone usually does not cause thrombocytopenia, unless a significant amount of radiation is directed at the pelvis, the patient is receiving chemotherapy at the same time, or the cancer spreads to the bone Thrombocytopenia may also occur when cancer cells, such as leukemia or lymphoma cells, crowd normal bone marrow cells. Although rare, thrombocytopenia can occur when other cancers, such as prostate or breast cancer, spread to the bone marrow Cancer of the spleen is another uncommon cause of thrombocytopenia. Excess platelets are stored in the spleen, and cancer of the spleen can cause the spleen to enlarge, trapping too many platelets

4 There are two main causes of a low platelet count Not enough platelets being made in the bone marrow Conditions that can cause too few platelets to be made include aplastic anaemia, cancers in the bone marrow, such as leukaemia, cirrhosis (scarring of the liver), folate or vitamin B12 deficiency and myelodysplastic syndrome (where the bone marrow does not make enough blood cells or makes defective cells The use of certain drugs may also lead to a low production of platelets in the bone marrow the most common example here is chemotherapy treatment and Druginduced - eg, heparin, ibuprofen, quinine, Cytosine arabinoside, and vancomycin Viral infections, including chickenpox, parvovirus, hepatitis C, Epstein-Barr, mononucleosis, or HIV Severe bacterial infection in your blood Inherited platelet function disorders: von Willebrand's disease (vwd), It is usually associated with a low plasma factor VIII level Immune - idiopathic thrombocytopenia purpura (ITP), systemic lupus erythematosus, rheumatoid arthritis, sarcoidosis, antiphospholipid syndrome and can be treated by one of these: a) Eltrombopag, b)! Rituximab c) Cyclosporin, d) Cyclophosphamide. It is more common in women than men, and It may be treated by gammaglobulin infusions Increased breakdown of platelets in the bloodstream or in the spleen/liver Increased breakdown of platelets either in the bloodstream or in the spleen/liver can be caused by disseminated intravascular coagulation (DIC), drug-induced thrombocytopenia (immune or non-immune types), hypersplenism (swollen spleen), immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura

5 What tests are needed? Low platelet count can be picked up on a routine blood test. Blood tests include a full blood count (FBC) and blood clotting studies, such as the partial thromboplastin time (PTT) and prothrombin time (PT). Other tests that may help diagnose this condition include bone marrow aspiration or biopsy

6 How is thrombocytopenia treated? The treatment and long-term outcomes of thrombocytopenia depends on the cause of the condition In some cases, a transfusion of platelets may be required to stop or prevent bleeding The main complication of thrombocytopenia is severe bleeding and this may occur in the brain or gastrointestinal tract Polycythaemia vera is associated with a rise in platelet counts: is a neoplasm in which the bone marrow makes too many red blood cells. It may also result in the overproduction of white blood cells and platelets

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