Malfunction Of The Immune System And Itp
The bodys immune system is a specialised system of cells and chemicals that fight infections. Normally, the immune system recognises self and doesnt attack tissues or organs of the body.
Doctors think that some types of viral infections trigger ITP. For reasons unknown, these infections prompt the persons lymph tissues and spleen to make antibodies that attack the platelets in their blood. Antibodies that attack the body are called autoantibodies. In other cases, the cause is unknown .
Platelets are made in our bone marrow. Since ITP targets mature platelets as they circulate through the spleen, the newborn platelets inside bone marrow are healthy and normal. In many cases of acute ITP, the platelet count will rise again within a few weeks and return to normal within a few months.
If Your Normal Is Lower Than The Defined Normal Range
percentage of the population that has a lower resting state level of white blood cellsdo not necessarily predispose you for an increased risk of infection
If you have a history WBC levels just below the 4.0 thousands/L normal cutoff and you havent experienced a high incidence of illness throughout your life, you likely just have a lower resting state. It is still important to discuss your findings with your physician to rule out the need for any additional testing.
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Symptoms Of Low Platelets
A low platelet count can cause a variety of symptoms. Call your doctor if you notice these issues or if they become more frequent or severe:
- Easy bruising, also called purpura
- Petechiae, tiny red spots on your skin
- Excess bleeding after even minor injuries
- Pain in your joints, particularly large joints like the knees and hips
It is important to call your healthcare provider at once if you have any of the following symptoms:
- Headache, confusion, or dizziness
- Vaginal bleeding after menopause or unusually heavy vaginal bleeding
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Are There Any Risks To The Test
After a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is very little risk to your baby or child with a needle stick test. Your child may feel a little pinch when the site is poked, and a small bruise may form at the site. This should go away quickly.
What Are The Treatment Options
Treatments vary depending on the type of disease, and can include simple observation, use of steroids and other immune-modulating therapies, transfusions or coagulation factor support, growth factor supplementation, complex chemotherapy and bone marrow transplantation.
Anemia
For chronic anemia, the underlying disease is attended to, often improving the anemia. If thats not possible and the patients anemia is causing symptoms, red blood cell transfusions may be necessary. Recombinant human erythropoietin can be given, weekly or biweekly, and usually indefinitely. The erythropoietins are also useful in other types of anemia in which there is an underproduction of red blood cells in the bone marrow, such as chemotherapy-induced anemia, myelodysplastic syndrome, and aplastic anemia. They are particularly useful in the anemia of kidney disease which is caused by an underproduction of erythropoietin in certain specialized cells of the kidney.
If nutritional deficiencies are the cause, oral iron tablets, vitamin B12 injections, or and oral folic acid may be prescribed.
Thrombocytopenia
Myeloproliferative diseases-polycythemia vera, essential thrombocythemia, and primary myelofibrosis
Coagulation disorders
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What Can I Do To Avoid/prevent A Low White Blood Cell Count
To minimize the chances of certain diseases and a low white blood cell count:
- Practice good hygiene. For instance, wash your hands after using the bathroom and before cooking.
- Be careful around pets and other animals that might transmit infections.
- Make sure foods are thoroughly cooked before eating them.
- Stay away from people who have infections.
- Practice safe sex avoid drugs and sharing needles.
What Causes Low Platelets In Pregnancy
Outside of pregnancy, a normal platelet count ranges from 150,000 to 450,000/µL .
Itâs normal for your platelet count to dip by a few thousand during pregnancy, due in part to hemodilution: the body makes more plasma during pregnancy, so the total number of platelets per volume of blood will be lower.
When the number dips below 100,000-150,000/µL, your doctor will want to keep a closer eye on you to reduce the risk of complications.
During pregnancy, about 10 percent of women have platelets counts below 150,000/µL. Of these, approximately:
- 75 percent are due to normal changes in pregnancy
- 21 percent are related to hypertensive diseases, such as preeclampsia or HELLP syndrome
- 4 percent are due to inherited or immunological conditions in which the immune system makes antibodies which attack platelet cells
Approximately 1 percent of patients have platelets counts of less than 100,000/µL, which might impact pregnancy management.
Platelets may be destroyed at a higher rate in pregnancy. As the spleen increases in size due to increased blood volume during pregnancy, it may destroy more platelets in the filtering process.
A severe lack of folic acid in your blood can cause thrombocytopenia, so it is important to take your prenatal vitamins. Certain bacterial and viral illnesses such as Epstein-Barr, HIV, and hepatitis B and C can also lower your platelet count.
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Stopping Treatments Or Medications That Cause Leukopenia
Sometimes you may need to stop a treatment to give your body time to make more WBCs. Your blood cell counts may naturally rise when treatment like radiation is over or between chemotherapy sessions. The amount of time it takes for WBCs to replenish varies from person to person.
If youre taking a medication that causes leukopenia, your doctor may adjust the dose that youre taking. They may also recommend switching to a different medication, if possible.
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What Questions Should I Ask My Healthcare Provider
You may want to ask your healthcare provider:
- Why did I get thrombocytopenia?
- What is the best treatment for me?
- Are there any treatment risks or side effects?
- What changes can I make to minimize bleeding and bruising?
- Should I watch for signs of complications?
A note from Cleveland Clinic
If you have conditions that increase your risk for thrombocytopenia, its important to take precautions to protect your health. A low platelet count can put you at risk for excessive bleeding and bruising. Your healthcare provider can explain whats causing the low platelet count and discuss treatment options. If your condition is severe, you may need to avoid activities that increase your risk of injury and bleeding.
Last reviewed by a Cleveland Clinic medical professional on 11/23/2020.
References
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Definition Of Low White Blood Cell Count
The correct term for a blood test or exam is called complete blood count or CBC. Doctors often order a CBC because it analyzes the numbers of cell components, including white blood cells. The normal threshold for white blood cell count may differ. Mayo Clinic states that the normal range is 3.5 billion to 10.5 billion cells per liter of blood. Meanwhile, MEDLINE Plus states that the normal 4,500 to 11,000 white blood cells per microliter .
A CBC is the only way to determine the numbers of white blood cells in the body. Your doctor may order several CBC tests to monitor your blood cell counts.
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What Causes Idiopathic Thrombocytopenic Purpura
In ITP, the immune system is stimulated to attack your bodys own platelets. Most often this is a result of antibody production against platelets. In a small number of cases, a type of white blood cell called T-cells will directly attack platelets. This immune system error may be a result of any of the following:
- Medications can cause an allergy that cross-reacts with platelets.
- Infections, typically viral infections, including the viruses that cause chicken pox, hepatitis C, and AIDS, can prompt antibodies that cross-react with platelets.
- Immune disorders, such as rheumatoid arthritis and lupus
- Low-grade lymphomas and leukemias may produce abnormal antibodies against platelet proteins.
- Sometimes the cause of immune thrombocytopenic purpura is not known.
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What Are The Complications Of Thrombocytopenia
People with severe thrombocytopenia are at risk for significant internal and external blood loss, or hemorrhage. Internal bleeding into the digestive tract or brain can be life-threatening.
Having a splenectomy makes you more susceptible to infections. Your spleen is part of your immune system. It helps your body fight off germs. For this reason, patients who have to have their spleen remove are given several vaccinations to help prevent infection.
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What Causes Low Platelet Count
Low platelet count can be caused by multiple factors, and in many cases, it is easily reversed.
Changing your medications or diet, or addressing the health condition behind the lowered count may be accomplished rather quickly.
For cases where platelet production is the focus of care, medicines can boost counts in a hurry as well. Therefore, mitigating the risk of thrombocytopenia is quite possible when the appropriate diagnosis is made and action taken immediately.
The main causes of thrombocytopenia are:
- Insufficient production of platelets by the bone marrow
- Rapid destruction or overuse of platelets
- Excess, or trapped, platelets in the spleen
Some other causes of low platelet counts include:
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Food Allergies Food Intolerance And Fatigue
Symptoms: Fatigue, sleepiness, continued exhaustion
Although food is supposed to give you energy, medical research suggests that hidden food intolerances or allergies can do the opposite. In fact, fatigue may be an early warning sign of food intolerance or food allergy. Celiac disease, which happens when you cant digest gluten, may also cause fatigue.
Ask your doctor about the elimination diet. This is a diet in which you cut out certain foods linked to a variety of symptoms, including sleepiness within 10 to 30 minutes of eating them, for a certain period of time to see if that makes a difference. You can also talk to your doctor about a food allergy test or invest in a home test such as ALCAT which may help you identify the offending foods.
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Do Low Platelets Make You Feel Tired
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Low platelets make you feel tired because platelets are an important part of your blood which carry oxygen to all the important parts of your body, including your muscles and brain, and also take care of clotting and bleeding, and low numbers of these structures can even be life-threatening.
When your muscles and brain are low on oxygen due to not enough platelets in your blood, you can feel tired and lazy, and the condition can worsen further if you do not seek immediate treatment.
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How Can I Prevent Thrombocytopenia
If youre at risk for thrombocytopenia, these steps may help prevent it:
- Avoid medicines that thin blood and increase bleeding risk, such as aspirin, naprosyn and ibuprofen.
- Take care with contact sports and activities that can cause injuries, bruising and bleeding.
- Minimize contact with toxic chemicals.
- Take extra care when shaving, brushing your teeth and blowing your nose.
- Limit your intake of alcohol which slows down the production of platelets and causes liver damage.
How To Treat A Low Platelet Count
If you notice that youre developing bruises more easily and bleeding for a long period of time even after only getting a minor cut, talk to your doctor to check your platelet counts. A diagnosis of a low platelet count can be made using several tests: a complete blood count, which measures the levels of all blood cells/platelets in your blood a blood smear, which looks at the actual shape of your platelets or bone marrow tests and blood clotting tests to check for proper production and function of platelets. You might also need an ultrasound to check your spleen to see if its enlarged and possibly tapping platelets inside.
Sometimes thrombocytopenia is only mild and doesnt even need to be treated, since blood can still clot normally enough. Other times if it becomes severe, your doctor might need to prescribe medications to help ensure blood can clot or change the medications you currently take to stop their side effects. Medications and treatments used to stabilize severely low platelet counts can include platelet transfusions, splenectomy , corticosteroids or immunoglobulins, which block effects of the immune system.
Once a diagnosis has been made, you can use the recommendations below to help raise your blood platelet counts, manage symptoms and prevent complications from developing:
1. Improve Your Diet
2. Decrease or Eliminate Alcohol and Sugary Drinks
3. Reduce Exposure to Toxic Chemicals
4. Decrease or Stop Using Painkilling Drugs
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Doctors Notes On Thrombocytopenia
Thrombocytopenia is a condition where there is an abnormally low level of platelets in the bloodstream. Signs and symptoms of thrombocytopenia usually include some aspect of increased bleeding. For example, signs and symptoms include
Other signs and symptoms may include enlargement of the spleen, fatigue, anemia, and/or jaundice.
There are three major causes of thrombocytopenia and are as follows: impaired production of platelets increased destruction of platelets and sequestration of platelets in the spleen. These three major causes also have underlying causes
- impaired production of platelets, for example, can be due to problems with the bone marrow where platelets are synthesized.
- Consumption or destruction of platelets can occur with certain medications , transfusion reactions, rheumatologic conditions like systemic lupus erythematosus, immune destruction , and
- other causes like vasculitis, , chemotherapy, hemolytic uremic syndrome or the HEELP syndrome in pregnant women. If the spleen enlarges for any reason , it can remove abnormal amounts of platelets from the blood.
Other causes can be related to dilution and some rare genetic conditions.
What are the treatments for thrombocytopenia?
- Medications like corticosteroids
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Increased Platelet Destruction Or Consumption
Many medical conditions can cause the platelet cells to destroy themselves earlier than they should. Sometimes it can be caused because a person is using medications that will have that side effect like Heparin and some forms of antibiotics.
In other cases, it can be related to some rheumatologist conditions such as lupus, HELLP syndrome, severe infections or injury, or inflammations of the blood vessels.
Bone Marrow Aspiration And Biopsy
A bone marrow test may also be performed. There are two types of bone marrow tests: a biopsy and an aspiration. In some cases, both tests may be performed at the same time.
During a bone marrow aspiration, a small amount of bone marrow is removed from one of your bones.
In a bone marrow biopsy, a sample of your core bone marrow is removed, usually from the hipbone.
The treatment options for a low platelet count can vary. Your doctor or specialist will determine the appropriate treatment for low platelet counts based on the underlying cause and severity of your condition.
If the condition is mild, your doctor may choose to simply monitor you.
If your low platelet count is more severe, you may need medical treatment. Treatment options may include:
- blood or platelet transfusions
- changing medications that are causing a low platelet count
- Prescribing steroids, immune globulin, or other medicines that suppress your immune system
- spleen removal surgery
contact sports that put you at risk for bleeding injuries, or talk to your doctor about safety measures.
If your spleen has been removed, watch for potential signs of infection as the removal of the spleen can increase the risk and seek medical attention if you start to feel ill or have a fever.
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How Is Thrombocytopenia Diagnosed
Thrombocytopenia or Idiopathic Thrombocytopenia, which refers to low platelet count without any known cause, can be diagnosed in a number of ways.
ITP is suspected when a patient comes in with specific complaints and shows no history of any other disorders or substance use that would otherwise cause such a problem.
The doctor may use a number of diagnostic means to diagnose Thrombocytopenia, some of which are given below.
The doctor may ask some questions regarding what symptoms, most importantly any bleeding you may have noticed.
They may ask when did you first see them, or if anything makes them better or worse, information about any medications and supplements you may be taking.
They may also want to know if you have had any shots in the last month or a blood transfusion, or used drugs with a needle?
Some questions may feel scary but you have to try to answer them as honestly as you can so a diagnosis can be made.
They may also want to know if you have any family history of excessive bleeding and other blood-related disorders.
The doctor may also check for signs of bleeding, both internal and external, and palpate your stomach to see if your spleen seems big.
There are some tests to check for low platelet levels as well:
· CBC . This test aims to measure the total number of your red and white blood cells as well as platelets.
· Blood smear is a test used to see how your platelets look under a microscope.
