What Is Thrombocytopenia?

Platelet transfusion
Platelet transfusion. Harry Sieplinga/Photographer's Choice/Getty Images


Thrombocytopenia is a low platelet count.  Platelets are one of our blood cells that help us to stop bleeding.  Thrombocytopenia is defined as a platelet count less than 150,000 cells/mL.   


Symptoms of thrombocytopenia are related to the increase risk of bleeding. 

  • Nosebleeds 

  • Bleeding from gums 

  • Blood in urine or stool 

  • Blood blisters in the mouth 

  • Easy bruising 

  • Small red dots that look like a rash called petechiae 


    • Viruses:  During viral infections your bone marrow may temporarily make fewer platelets called viral suppression.  Once the virus is cleared from the body, the bone marrow can resume normal production. 

    • Medications:  Certain medications can inhibit the body's ability to make platelets or destroy  the platelets. The list of medications that cause thrombocytopenia is long and includes antibiotics (vancomycin, trimethoprim/sulfamethoxazole, rifampin, and others), ranitidine (Zantac), medications that treat malaria, and valproic acid (anti-seizure medication).

    • Immune thrombocytopenia:  This is a condition where the immune system becomes confused and destroys the platelets. 

    • Malignancy:  Certain cancers, particularly leukemia, may cause a decreased platelet count.  

    • Chemotherapy:  Chemotherapy attacks rapidly dividing cells including blood cells.  Chemotherapy can cause anemia, leukopenia, and thrombocytopenia.  

      • Aplastic Anemia:  In this condition the bone marrow cannot make the blood cells normally which may result in thrombocytopenia.   

      • Inherited thrombocytopenia:  There are inherited conditions like Bernard Soulier and MYH9 related diseases that result in thrombocytopenia. 

      • Splenomegaly:  A portion of our platelets are stored in our spleen, an organ in the immune system.  If the spleen becomes enlarged, more platelets are trapped in spleen resulting in thrombocytopenia.   

      • Thrombotic thrombocytopenic purpura:  This conditions causes small clots to form in the blood vessels which consumes the platelets.  

      • Pregnancy:  Thrombocytopenia can occur more than 5% of normal pregnancies or may be the result of pre-eclampsia.  


      Thrombocytopenia is diagnosed on a complete blood count (CBC).  This could be drawn as part of an annual physical exam or because you present to your physician with bleeding symptoms.  To determine the cause of your thrombocytopenia your physician will need to send additional labs.  This will likely include a peripheral blood smear where the blood cells are inspected under a microscope.  The appearance of the platelets may indicate the underlying cause of the low platelet count.  Additionally, tests that assess the function of platelets, like platelet aggregometry, may assist in diagnosing the cause of thrombocytopenia.  


      Treatment is determined by bleeding symptoms and cause of thrombocytopenia.  All patients with thrombocytopenia should avoid aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen as these medications decrease the platelets ability to form a clot.


      • None:  If your thrombocytopenia is mild or if you have no active bleeding treatments, you may not require any treatments.
      • Platelet transfusions:  Transient thrombocytopenia, as seen during chemotherapy treatments, can be treated with platelet transfusions.  
      • Stopping medications:  If your thrombocytopenia is the result of a medication, your healthcare provider might stop that medication.  This is a balancing game.  If your condition is well controlled on the medication and your thrombocytopenia is mild, your health care provider may continue this medication.
      • Medication:  If your thrombocytopenia is the result of immune thrombocytopenia (ITP), you may be treatment with medications like steroids, intravenous immunoglobulin, or anti-D immune globulin. 
      • Splenectomy:  In many types of thrombocytopenia, the spleen is the primary location of destruction of the platelets or trapping of the platelets.  Surgical removal of the spleen may improve your platelet counts.  
      • Plasma exchange:  Thrombotic thrombocytopenic purpura (TTP) is treated with plasma exchange.  In this procedure your plasma is removed via an apheresis machine and is replaced with fresh frozen plasma.  

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