Thrombocytopenia (low platelet count)

Diagnosis

Your healthcare professional will ask you a number of questions about symptoms, health history, medicines and symptoms. The following will likely be used to determine whether you have thrombocytopenia:

• Blood test. A complete blood count determines the number of blood cells, including platelets, in a sample of your blood. Your healthcare professional may compare the results of a recent test with past tests.
• Blood smear. This is a lab test to look at a sample of blood under a microscope to count platelets. A specialist looks for clumping or irregular platelets and looks at other blood cells.
• Physical exam. Your healthcare professional will look for signs of bleeding under your skin, gums or lining of your mouth. Your care professional will examine the size or tenderness of the spleen, liver and lymph nodes.

Your care professional might suggest other tests and procedures to determine the cause of your condition depending on your signs and symptoms.

Treatment

People with mild thrombocytopenia might not need treatment. Treatments for more-serious cases depend on the cause and the risk of complications.

Treating the cause may include:

• Stopping a medicine that likely caused thrombocytopenia.
• Treating an underlying disease, such as an infection or cancer.

Other treatments might involve:

• Medicines. If thrombocytopenia is related to an immune system disorder, medicines may be used to control immune system activity. The most common medicine is a corticosteroid.
• Platelet transfusions. Platelet transfusions use donor platelets to boost the number of platelets in the bloodstream. They are delivered through a needle into a vein. Platelet transfusions may be used when a platelet count is too low.
• Plasma exchange. In some cases, a severe risk of blood clotting may require a plasma exchange. With this procedure, blood circulates from the person to a machine that removes plasma and replaces it with donor plasma or a plasma substitute. The blood then circulates back to the person.
• Surgery. Surgery to remove the spleen is called a splenectomy. This may be done to remove an enlarged or diseased spleen. Removing the spleen also may be needed when other treatments do not improve a low platelet count.

Lifestyle and home remedies

If you have thrombocytopenia, try to:

• Avoid activities that could cause injury. If a job carries a risk of injury, use protective gear and follow safety guidelines. Ask your healthcare professional if you should avoid contact sports that increase the risk of injury. Wear a helmet when bicycling, skateboarding or participating in similar activities.
• Avoid alcohol. Alcohol slows the production of platelets in your body. Ask your care professional whether it's OK for you to drink alcohol.
• Use caution with nonprescription medicines. Pain medicines, such as aspirin and ibuprofen (Advil, Motrin IB, others), can prevent platelets from working properly. Acetaminophen (Tylenol, others) is a better alternative.

Preparing for your appointment

If you have symptoms of thrombocytopenia, start by seeing your primary healthcare professional. Also, a low platelet count may be found in a complete blood count test during an annual checkup or with tests for another condition.

You may be referred to a specialist in blood diseases, called a hematologist, or another specialist depending on the possible cause of a low platelet count.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

Make a list of:

• Warning signs you've noticed, such as any unusual bruising or bleeding or any rashes. Note when they began. Write down any other symptoms even if they don't seem related to your main concern.
• Key personal information, including recent illnesses or medical procedures such as a blood transfusion, major stresses or recent life changes.
• All medicines, vitamins and other supplements you take, including doses and the reasons for taking them.
• Questions to ask your healthcare professional.

Take along a family member or friend, if possible, to help you remember the information you receive.

Questions to ask your healthcare professional might include:

• How many platelets do I have in my blood?
• Is my platelet count dangerously low?
• What is causing my thrombocytopenia?
• Do I need more tests?
• Is my condition likely temporary or chronic?
• What are my treatment options?
• What will happen if I do nothing?
• Are there any restrictions that I need to follow?
• Are there printed materials I can have? What websites do you recommend?

What to expect from your doctor

Questions your healthcare professional might ask include:

• Do you bruise easily?
• Have you experienced excessive bleeding with minor injuries?
• Have you have had bleeding from your gums?
• Is there a history of bleeding disorders or thrombocytopenia in your family?
• Have you recently started a new medicine?
• Are there medicines you take off and on?
• Where have you traveled recently?
• Have you recently had or been exposed to a bacterial or viral disease?
• How much alcohol do you drink?
• Do you have any restrictions in your diet?
• Have you had any unexpected weight loss or change in appetite?
• Have you had any bone pain?

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