Thrombocytopenia

Thrombocytopenia is an abnormal drop in the number of blood cells involved informing blood clots. These cells are called platelets. The normal amount ofplatelets is usually between 150,000 and 450,000 cells per microliter of blood. A microliter is an amount equal to one one-millionth of a liter (a liter is almost equal to a quart). Platelet numbers are counted by having a blood sample collected and placing a measured amount of blood in a machine called a cell counter. When the platelet number drops below 150,000 cells per microliter of blood, this person is said to be thrombocytopenic.

Abnormal reductions in the number of platelets are caused when abnormalitiesoccur in any of the following three processes: decreased platelet productionby the bone marrow; increased trapping of platelets by the spleen; or a morerapid than normal destruction of platelets. Persons with this condition easily bruise and can have episodes of excess bleeding (a hemorrhage).

Platelets come from megakaryocytes, which are produced in the material located within the center cavity of the bones (bone marrow). When abnormalities develop in the marrow, the marrow cells can lose their ability to produce platelets in correct amounts. The result is a lower than normal level of plateletsin the blood. Drugs used in cancer chemotherapy can cause the marrow to malfunction in this way, as can the presence of tumor cells in the marrow itself.

Normally, the spleen holds about one-third of the body's platelets as part ofthis organ's function to recycle aging or damaged red blood cells (the cellsthat carry oxygen in the blood). When liver disease or cancer of the spleenis present, the spleen can enlarge, resulting in a greater number of platelets staying in the organ. This condition results in abnormally low numbers of platelets in the blood.

Platelets can breakdown in unusually high amounts in persons with abnormalities in their blood vessel walls, with blood clots, or with man-made replacement heart valves. Devices placed inside blood vessels to keep them from closing(stents) due to weakened walls or fat build-up can also cause platelets to breakdown. In addition, infections and other changes in the immune system canspeed up the removal of platelets from the circulation.

Thrombocytopenia is diagnosed by having a blood sample taken and counting theplatelets present in the sample. However, accurately determining the medicalreason for this conditions is complex. Once a low platelet count is verified, a careful evaluation of the function of the bone marrow and spleen are necessary. Improper functioning of either or both of these organs can cause thrombocytopenia. In addition, the causes for the abnormal spleen or marrow function must be investigated since different cancers, blood disorders, or liver disease can be the true cause for the drop in platelets found in the blood.

If low platelet counts are caused by an enlarged spleen, removal of the spleen can help raise the platelet level, since the spleen is no longer there to capture the platelets. However, proper treatment for what causes the enlargedspleen is necessary as well. Low platelet counts can indicate more serious conditions. If a dysfunctional immune system is found to be the cause for thiscondition, drugs like steroids or gamma globulin can be used to help maintainplatelet levels in certain cases. If low platelet levels are due to an abnormally low level of platelet production, transfusions of platelets can be given as well.

There is no known way to prevent thrombocytopenia.

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