What are the risk factors for thrombocytopenia?

Thrombocytopenia is a bleeding disorder. People with the condition usually have fewer platelets in the blood than those without thrombocytopenia.

Platelets are a type of blood cell that the marrow produces. They help stop bleeding by helping with blood clotting.

When a person has a low platelet count, their blood may have issues with clotting, which may cause spontaneous and internal bleeding, rashes, and bruising.

In this article, we look at common causes of thrombocytopenia, lifestyle risk factors, symptoms, treatment options, and whether the condition is preventable.

Common causes of thrombocytopenia

Three factors can lead to a low platelet count. Each potential cause of thrombocytopenia may therefore fall under one of three areas.

1. The body not making enough platelets

A person’s body might not create enough platelets if stem cells in the bone marrow become damaged. It is the stem cells that eventually develop into platelets.

The following factors can cause stem cells to become damaged and platelet production to slow:

• viruses, such as mumps, rubella, and HIV
• some genetic conditions, such as Wiskott-Aldrich syndrome
• heavy alcohol consumption
• some medications, such as diuretics
• aplastic anemia, a condition that reduces blood cell production
• cancers, such as leukemia and lymphoma
• some cancer treatments, such as radiation and chemotherapy.

2. The body destroying platelets

Even if the bone marrow produces enough platelets, several factors can cause the body to destroy them, which can lead to thrombocytopenia. These potential causes include:

• infectious diseases, such as mononucleosis and cytomegalovirus
• autoimmune conditions, such as lupus, rheumatoid arthritis, and immune thrombocytopenia
• some medications, such as nonsteroidal anti-inflammatory drugs, heparin, and quinine
• surgery where the blood passes through artificial valves, machines, or tubing
• pregnancy
• some rare conditions that cause blood clots, such as thrombotic thrombocytopenic purpura.

3. The spleen holding on to platelets

The spleen typically holds around a third of the body’s platelets. However, this organ can sometimes end up holding onto more, which reduces the platelets that can circulate in the blood.

The spleen can hold on to too many platelets if it becomes enlarged. Possible causes include:

• cirrhosis, which is scarring of the liver
• myelofibrosis, which refers to scarring of the bone marrow
• Gaucher’s disease
• cancer.

Lifestyle risk factors

Some lifestyle factors may increase the risk of thrombocytopenia, including:

• Alcohol consumption: People who drink excessive amounts of alcohol have a higher risk of developing thrombocytopenia.
• Certain over-the-counter (OTC) medications: These may affect platelets. They include ibuprofen and aspirin.
• Diet: Some diets may help improve a person’s platelet counts. These include diets high in foods containing folate, B12, and iron.

Can you prevent it?

Usually, a person cannot prevent thrombocytopenia. However, this depends on the cause of the disorder.

A person can take measures to help prevent health problems that have links to thrombocytopenia. These approaches include:

• avoiding toxic chemicals, such as pesticides, benzene, and arsenic, which can slow platelet production
• avoiding medicines that may impact platelet count or cause blood thinning
• discussing vaccinations for viruses that can affect platelets with a doctor, such as those for the mumps, measles, and rubella
• following a well-rounded diet, including B12, folic acid, and iron supplements if following a vegetarian or vegan diet

Symptoms

Symptoms of thrombocytopenia may include:

• nosebleeds that last a long time and are difficult to stop
• easy and spontaneous bruising
• bleeding gums
• a rash which appears as small red or purple dots
• blood blisters inside cheeks
• heavy and prolonged menstrual bleeding
• rarely, bleeding on the brain, called intracranial hemorrhage
• rarely, signs of internal bleeding such as blood in stool, vomit, or urine.

Treatment options

A doctor will treat thrombocytopenia depending on the cause and severity of the disorder. Treatments may include:

• 0Medication: These may be corticosteroids, such as prednisone, methylprednisolone, dexamethasone, or thrombopoietin receptor agonists (TPO-RAs), which include:
• romiplostim (Nplate)
• eltrombopag (Promacta)
• avatrombopag (Doptelet).
• Immunoglobulin transfusion: Immunoglobulins help slow the rate at which the body destroys platelets.
• Platelet transfusion: In an emergency, a doctor may add platelets to a person’s blood. However, the immune system will likely destroy the new platelets, so this treatment will not cure the condition.
• Surgery: A doctor may suggest a splenectomy, which involves removing the spleen.

Summary

Common causes of thrombocytopenia include autoimmune diseases, certain medications, and infectious diseases.

Lifestyle risk factors may include heavy alcohol consumption and taking OTC medications that affect platelet count or thin the blood.

Usually, people cannot prevent the disorder. However, they may be able to decrease the risk of certain symptoms by avoiding medications that affect platelets and getting vaccinated against viruses that may cause the disorder.

Symptoms of thrombocytopenia include nosebleeds, bleeding gums, fatigue, and bruising easily. A doctor may treat the disorder using corticosteroids or TPO-RA medication, platelet transfusions, or surgery to remove the spleen.

Source: Medical News Today

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