Overview & Definition
Platelets (thrombocytes) are essential blood components responsible for blood clotting and stopping bleeding. Platelet disorders occur when platelet counts fall too low (thrombocytopenia) or rise too high (thrombocytosis), leading to bleeding risks or abnormal clotting.
Types & Classification
- Immune Thrombocytopenia (ITP)
- Thrombotic Thrombocytopenic Purpura (TTP)
- Heparin-Induced Thrombocytopenia (HIT)
- Essential Thrombocythemia (High Platelets)
- Platelet Storage Pool Defects
Underlying Causes & Risk Factors
- Autoimmune destruction of platelets
- Viral infections (Dengue, Hepatitis, HIV)
- Bone marrow suppression or leukemia
- Drug-induced anti-platelet antibodies
- Spleen sequestration (Splenomegaly)
Common Symptoms & Warning Signs
Diagnostic Evaluation
Accurate diagnosis requires comprehensive laboratory investigation under expert hematological supervision:
- 🔍 Serial CBC & Platelet Count Assessment
- 🔍 Peripheral Blood Film Microscopy
- 🔍 Bone Marrow Aspiration to evaluate Megakaryocytes
- 🔍 Viral Serology & Autoantibody Testing
- 🔍 Coagulation Profile & D-Dimer Assessment
Treatment Options & Clinical Management
- 💊 First-Line Immunosuppression for ITP – Corticosteroids (Dexamethasone / Prednisone) and IVIG (Intravenous Immunoglobulin).
- 💊 Second-Line Targeted Therapies for ITP – Thrombopoietin Receptor Agonists (Eltrombopag, Romiplostim, Avatrombopag) and Rituximab.
- 💊 Urgent Therapeutic Plasma Exchange (TPE) & Caplacizumab – for Thrombotic Thrombocytopenic Purpura (TTP), where routine platelet transfusions are contraindicated.
- 💊 Platelet Transfusions – indicated for acute critical mucosal or intracranial bleeding in severe ITP, but contraindicated in TTP and HIT.
Frequently Asked Questions
Early signs include pinpoint red/purple spots on lower legs (petechiae), larger purple skin bruises (purpura), frequent nosebleeds (epistaxis), bleeding gums, and unusually heavy menstrual cycles (menorrhagia).
Diagnosis begins with serial complete blood counts and expert peripheral blood smear microscopy (excluding pseudothrombocytopenia), viral serology (HCV, HIV, Dengue), ADAMTS13 activity testing (for suspected TTP), and bone marrow examination when secondary bone marrow failure is suspected.