Disorders that negatively affect how many platelets you have and how they work are called platelet disorders. For example, thrombocytosis (high platelets), thrombocytopenia (low platelets), and platelet dysfunction (in such cases, the platelets do not work properly). While in most cases the symptoms are mild, some people may develop severe enough symptoms that they need immediate medical care.
In general, platelets are specific cells that bind together to form clots if you are injured. Furthermore, they act like a bandage that stops bleeding.
Types of Platelet Disorders
Healthcare professionals have divided this disorder into 3 types. For example:
- Thrombocytosis (an increased level of platelets)
- Thrombocytopenia (reduced level of platelets)
- Platelet dysfunction (the level of platelets is normal, but they are not working properly)
Symptoms
Usually, people with platelet disorders experience the following symptoms. Examples include:
- Bruises (also known as purpura) and pinpoint-sized spots (petechiae)
- Heavy menstrual periods
- Nosebleeds
- Bleeding gums
- Bloody urine or stools
- Weakness
- Dizziness
- Lightheadedness
- Abnormal blood clots
If you notice any of the previous symptoms, it is recommended to visit a healthcare professional.
Causes
The causes of platelet disorders are often different, and sometimes they can occur due to an underlying condition. However, some people inherit disorders from their biological parents that eventually cause platelet disorders.
Thrombocytosis Causes
An increased number of platelets may occur if you have gene mutations that cause an overproduction. It is known as essential thrombocythemia, but thrombocytosis often occurs in response to something else (reactive thrombocytosis). Check below some causes:
- Iron-deficiency anemia (low red blood cell count)
- Inflammatory disorders (such as cancer, infections, and others)
- Injuries
- Some medicines
Thrombocytopenia Causes
If your platelets are reduced, the body does not produce enough of them. However, it may also occur due to a disorder that destroys them. In most cases, the spleen stores about one-third of the platelets. Check below some possible causes of thrombocytopenia:
- Disseminated intravascular coagulation (DIC)
- Infections
- Blood disorders, such as thrombotic thrombocytopenic purpura (TPP)
- Autoimmune disorders (including immune thrombocytopenia)
- Blood cancers where the bone marrow becomes filled with cancerous (malignant) cells
- Certain treatments (such as medicines and cancer therapies)
Platelet Dysfunction Causes
Commonly, certain health conditions and medications negatively affect the platelet function even if you have a normal level. It may occur due to an acquired disorder or an inherited disorder. For example:
- Acquired disorders – Kidney failure, liver disease, lupus, and others.
- Inherited disorders – For example, Bernard Soulier syndrome, Glanzman thrombasthenia, Von Willebrand disease, and Wiskott-Aldrich syndrome.
- Medicines – These include SSRI antidepressants, NSAIDs (nonsteroidal anti-inflammatory drugs) such as Aspirin, and others.
Risk Factors
There are some factors that could make you more likely to develop platelet disorders. Check below some examples:
- Age
- Sex – While platelet disorders can affect anyone, females are more prone to these disorders than males due to menstruation and bleeding (such as during childbirth).
- A family history – If you have a parent or sibling with platelet disorders, your risk of developing them significantly increases.
- Certain diseases – These include autoimmune disorders, infections, liver and kidney disease, cancer, and others.
- Medicines – These include antibiotics, antiseizure medications, and others.
- Cancer treatments – For example, radiation therapy, chemotherapy, immunotherapy, and others.
- Lifestyle – People who misuse alcoholic drinks and/or tobacco products are also at increased risk of developing platelet disorders.
What Are The Potential Complications of Platelet Disorders?
Some people with platelet disorders can experience some complications, especially if they do not get treatment. Examples include:
- Hemorrhage
- Menorrhagia (heavy menstrual periods)
- Gastrointestinal bleeding
- Heart attack (also known as myocardial infarction)
- Deep vein thrombosis (DVT)
- Pulmonary embolism (usually in people with essential thrombocytosis)
- Stroke
- Brain bleeds
- Bone marrow problems
- Pregnancy complications (such as miscarriage)
- Anemia
- Infections
This document does not contain a full list of platelet disorder complications. However, you can talk with your doctor about ways to prevent or reduce the risk of the previous complications.
Diagnosis
In most cases, a platelet disorder diagnosis begins with a physical examination to check for abnormalities linked to the disease. Thereafter, doctors may also ask some questions about your family history and symptoms. Usually, doctors perform a blood test to check platelet levels. For example:
- Complete blood count (CBC) to check how many platelets are in the blood.
- Peripheral blood smear (PBS) to view your platelets under a microscope to check if they are looking normal.
- Platelet function tests – These tests are used to determine how effectively your platelets form clots.
Sometimes, physicians may perform additional tests to determine the exact cause of a platelet disorder. For example:
- Bone marrow biopsy – During this test, doctors will take a small sample of the bone marrow for testing. It often helps identify a blood disorder or cancer.
- Genetic testing – To perform this test, doctors need to get a sample of your blood. Usually, this test helps diagnose genetic disorders that may cause platelet disorders.
Treatment
Commonly, doctors prescribe different treatments for people with platelet disorders because it depends on several factors. These include the severity and type of the condition, overall health, medicines you are administering, age, and preferences. Check below some treatments often recommended for those who suffer from these disorders:
- Waiting – In some cases, when the symptoms are mild, doctors may not recommend any treatments, but perform regular blood tests to make sure the condition is not worsening.
- Medicines – Physicians usually prescribe medicines to reduce high platelet count if it is caused by essential thrombocytosis or other blood cancer (such as myeloproliferative disease).
- Platelet depletion – This treatment is recommended very rarely and involves the removal of excessive platelets from the blood.
- Platelet transfusion – This option is prescribed by doctors when the platelet count is very low.
- Plasma therapy – It is also known as plasma exchange, especially if you have a disorder called TTP. In general, the treatment goal is to replace missing parts of the blood known as ADAMTS13.
Frequently Asked Questions
When should I see my healthcare provider?
You should visit a doctor if you notice signs of a platelet disorder, including excessive and persistent bruising. However, it is recommended to call 911 or go to the nearest emergency room (ER) if you experience severe blood loss, blood clots, or signs of a stroke or heart attack, such as sharp chest pain.
What is the main cause of low platelets?
These include insufficient production in the bone marrow, increased destruction or consumption of platelets, and increased pooling of platelets in the spleen. However, thrombocytopenia can also occur due to certain medicines, viral infections, cancers, autoimmune disorders, pregnancy, liver disease, and other conditions.
How to increase platelet count in pregnancy?
Commonly, doctors recommend corticosteroids, IVIg, and dietary changes (including foods rich in vitamin C, such as berries and citrus, and fortified cereals). If you have additional questions, ask your healthcare provider.
