Thrombocytopenia

Thrombocytopenia is a blood disorder in which an abnormally low number of platelets impairs clotting and can lead to bleeding. It arises when the bone marrow makes too few platelets, when platelets are cleared at an increased rate, or when they are trapped in the spleen or liver. Causes include bone marrow failure or cancer, vitamin deficiencies, chemotherapy, cirrhosis and immune destruction of platelets. Some patients have no symptoms; others have bruising, nosebleeds, bleeding gums or petechiae, and severe bleeding in the brain or gut is the main complication. Diagnosis relies on a complete blood count, clotting tests, microscopic review of a blood film and sometimes a bone marrow biopsy. Treatment depends on the cause, and platelet transfusion may be needed to control or prevent bleeding. For immune thrombocytopenia, options include glucocorticoids, intravenous immune globulin, immunosuppressants and thrombopoietin receptor agonists such as romiplostim and eltrombopag, which stimulate platelet production.

Seek urgent care for unusual bleeding or bruising, breathlessness at rest, or a swollen painful leg. See a doctor for persistent tiredness, pale skin, or any symptom of anaemia in a man or a woman after the menopause, which always needs a cause to be found. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.