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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.
A.D.A.M. Medical Encyclopedia.
Thrombocytopenia is any disorder in which there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is sometimes associated with abnormal bleeding.
Causes, incidence, and risk factors
Thrombocytopenia is often divided into three major causes of low platelets:
- Not enough platelets are made in the bone marrow
- Increased breakdown of platelets in the bloodstream
- Increased breakdown of platelets in the spleen or liver
Your bone marrow may not make enough platelets if you have:
- Aplastic anemia
- Cancer in the bone marrow such as leukemia
- Cirrhosis (liver scarring)
- Infections in the bone marrow (very rare)
- Myelodysplasia
- Vitamin B12 deficiency
Use of certain drugs may also lead to a low production of platelets in the bone marrow. The most common example is chemotherapy treatment.
The following health conditions cause increased breakdown of platelets:
- Disseminated intravascular coagulation (DIC)
- Drug-induced immune thrombocytopenia
- Hypersplenism (swollen spleen)
Symptoms
You may not have any symptoms. General symptoms include:
- Bleeding in the mouth and gums
- Bruising
- Nosebleeds
- Rash (pinpoint red spots called petechia)
Other symptoms depend on the cause.
Signs and tests
Your health care provider will perform a physical exam and ask questions about your medical history and symptoms. The following tests may be done:
- Complete blood count (CBC)
Other tests that may help diagnose this condition include:
Treatment
Treatment depends on the cause of the condition. In some cases, a transfusion of platelets may be required to stop or prevent bleeding.
Expectations (prognosis)
The outcome depends on the disorder causing the low platelet counts.
Complications
Severe bleeding (hemorrhage) is the main complication. Bleeding may occur in the brain or gastrointestinal tract.
Calling your health care provider
Call your healthcare provider if you experience unexplained bleeding or bruising.
Prevention
Prevention depends on the specific cause.
References
- McMillan R. Hemorrhagic disorders: abnormalities of platelet and vascular function. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 175.
Review Date: 3/14/2012.
Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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The role of the monoclonal anti‐CD20 antibodies for treatment of patients with chronic lymphocytic leukaemia
Chronic lymphocytic leukaemia (CLL) is a malignant disease and accounts for 25% of all leukaemias. The disease is the most common lymphoid malignancy in western countries, and is characterised by a highly variable clinical course and prognosis. Some patients may have minimal or no symptoms for many years with a normal life expectancy, without requiring treatment. Other people are symptomatic at diagnosis or soon thereafter and can experience infectious and autoimmune complications, leading to a reduced lifespan. Standard treatment includes chemotherapy with one or more agents. Presently monoclonal antibodies are added, especially alemtuzumab and rituximab. However, the impact of these agents remains unclear, as there have been hints for increased overall survival, but also for an increased risk of severe infections in non‐randomised trials. In this systematic review we summarised and analysed the evidence from randomised controlled trials on efficacy and safety of monoclonal anti‐CD20 antibodies (such as rituximab and ofatumumab) in the treatment of CLL. We searched medical databases, such as EMBASE, MEDLINE and CENTRAL, and found seven randomised controlled trials fulfilling our inclusion criteria. Included trials compared anti‐CD20 antibodies, particularly rituximab, to no further therapy or compared to anti‐cancer therapy in CLL, irrespective of whether the patients were newly diagnosed or relapsed patients. Only five of the seven identified trials could be included in one of the two performed meta‐analyses.
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