Plateletopenia in brief Summary of thrombocytopenia

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Plateletopenia or thrombocytopenia	Indicative parameter of blood coagulative capacity: circulating platelets <150, 000 / mm3
Physiological amount of platelets in the blood	150, 000-400, 000 plates / mm3
Probability of spontaneous bleeding	Plateletopenia: 50, 000-150, 000 platelets / mm3 → hemorrhage can occur following trauma / surgery Plateletopenia: 20, 000-30, 000 platelets / mm3 → increases the risk of spontaneous bleeding Plateletopenia: <10, 000 platelets / mm3 → ascertained and worrying bleeding
Severe thrombocytopenia and related symptoms	Platelet hemorrhagic syndrome Bruising Epistaxis Gastrointestinal and / or urinary bleeding menorrhagia Brain hemorrhages The severity of the symptom depends on the value of thrombocytopenia
Risk factors for thrombocytopenia	History of leukemia Genetic predisposition Bone marrow failure Abuse of NSAIDs / drugs
Plateletopenia: causes	Plateletopenia due to excessive platelet consumption: disseminated intravascular coagulation bacterial infections vitamin B12 and B9 deficiency rare syndromes (eg May-Hegglin anomaly) frequent infections megaloblastic anemia eczema Platelet function due to destruction of thrombocytes: abuse of antibiotics / chemotherapy systemic diseases serious infections Thrombocyte thrombocytopenia: liver cirrhosis
Drug-induced thrombocytopenia	Intake of drugs → possible triggering factor for thrombocytopenia Problem: diagnostic difficulty to declare drug-induced thrombocytopenia with certainty Drugs involved: heparins quinine platelet inhibitors vancomycin antimicrobials antirheumatic diuretics analgesics chemotherapy synthetic substances able to favor the formation of anti-platelet antibodies Statistics: 10 cases / 1, 000, 000 of subjects affected by drug-induced thrombocytopenia
Drug-induced thrombocytopenia: symptoms	asymptomatic Petechial hemorrhages Slight ecchymoses Wet purple
Platelet infusion	10% of pregnant women: slight reduction of platelets during pregnancy → the platelet count still tends to remain in the physiological range Possible triggers: gestation, thrombotic microangiopathies, HELLP syndrome Measures: cortisone and immunoglobulins in the case of severe thrombocytopenia (platelets <30, 000mm3)
Platelet disease: diagnosis	use of EDTA as an anticoagulant substance palpation of the spleen ultrasound TC laboratory tests, such as thyroid function, platelet antibodies, phospholipid antibodies, etc. radioisotopic methods blood count marrow biopsy
Plateletopenia: therapies	Suspension of the responsible drug (thrombocytopenia induced drug) Platelet transfusion → reserved for severe cases (<10, 000 platelets / mm3) Controlled administration of corticosteroids, immunoglobulins and immunosuppressants (chronic forms of thrombocytopenia)