My wife was just told she has a low platelet count. What exactly does this mean? I thought it just mean she had thin blood, but I could be wrong. Any medical dopers out there that could be able to help me out with this one?
IANAD but IIRC low platelet counts are associated with hemophilia and more bleeding if cut because it interferes with clotting. I’m sure an expert will come along shortly and make me look stupid.
The formal medical term is thrombocytopenia. It means that her platelets will have a harder time clotting because there are fewer of them to go round. She may experience heavy menstrual periods, bruising, or spontaneous bleeding (e.g., gums or from her nose).
It’s hard to say what is causing hers or how to treat it, if treatment is indicated. Some of the reasons may be that: 1) her bone marrow doesn’t produce enough new platelets to keep up with demand, 2) her spleen captures platelets at a higher rate than what should be circulating, or 3) her autoimmune system is destroying platelets for some reason.
A physician may elect to perform regular blood tests on her to monitor the problem, or even have a bone marrow biopsy to rule out marrow disorders. They also may examine whether she has an enlarged spleen from a CT or ultrasound scan.
Hope this is helpful - you may want to google on “thrombocytopenia.”
How low? A while back I asked a question on how to increase platelet counts. Doesn’t really answer your question, but it’s just to show that I’m consistently a “low-sider,” and the Red Cross has never mentioned anything about needing to follow it up.
I don’t know the exact count, but it was enough to cause alarm. It doesn;t help any that my wife is also 37.5 weeks pregnant. I’m just wondering what some of the prognosises may be in plain language, since I don’t understand most medical terminology.
Thgrombocytopenia is usually an indicator of another underlying problem.In general there are three major catagories of thromobcytopenia,
1)Disorders of production
2)Disorders of destruction
3)Disorders of distribution.
1)There can be some serious or not so serious underlying conditions which may cause low platelet counts(normal female range 150-400x10^9/L) through decreased production. If there is ineffective thrombopoiesis in the marrow, cells fail to develop fully, for example malignancies in the bone marrow may cause damage. Damage at this level may also be acquired from the use of some therapeutic drugs. Viral infection and nutrional (especially B vitamins) can lower production, oh yeah alcohol, thats all I can think of right now.
2) Autoimmune disorders, antibody is produced to antigen on platelets, cells are attacked an lysed. Again, certain bacterial and viral infections may lower count by cell destruciton. Certain drugs especially opiates can destroy or use up platlets.
3)Low count due to platetet concentration in the spleen caused by cirrhosis, leukemias.
There are many reasons for thrombocytopeina, often times it is idiopathic and transitory, or platelets may simply be doing their job and being used up. My nephew had idiopathic thrompbocytopenia with petichiae(those little red dots where capillaries burst) He’s fine now. It is probably nothing , but it could be the begining of bigger problems. One last thing I’m just a lab rat, so please encourage her to get more blood work and an MD’s diagnosis.
Thrombocytopenia in late pregnancy has a few common causes:
5 to 10% of women late in pregnancy have mild to moderate reduction in platelet counts; it’s thought to be due to shorter platelet lifetime due to the pregnancy. So it may well be normal for her. Her doc will just need to keep an eye on it to prevent excessive bleeding at birth. This is the most common reason for thrombocytopenia late in pregnancy.
HELLP syndrome. How’s her liver and/or blood pressure? If her liver functions are elevated, it could be HELLP syndrome. Her doctor should be familiar with managing that too. It’s uncommon but not rare.
Idiopathic Thrombocytopenic Purpura. This is a disease that worsens during pregnancy, but is not caused by it. It’s possible that your wife had this, and it never got noted, or active, until now. Uncommon, not rare, very treatable. IF treatment is even needed.
There are more, even less common entities. This paper is rather technical, but does discuss the diagnosis of thrombocytopenia in late pregnancy. Again, focus on the fact that it’s very common to have low platelets during pregnancy, without anything being wrong.
This site has even better info on low platelets and pregnancy
I certainly can’t add to Qad’s and labmonkey’s excellent answers, but to clarify:
Low platelets are not associated with hemophilia. The latter condition involves deficiencies in the coagulation system (i.e. the proteins that help the blood clot) but not low platelet counts.
I also wanted to emphasize that drug-induced declines in the platelet count are quite common. Heparin, quinine, sulfa antibiotics, anticonvulsants, and many more, are all possible culprits.
Gimme a cite, please.
KarlGauss is certainly correct. Thrombocytopenia and hemophilia are different disorders. They do on occasion co-exist. I cite Dr. William Bell, Hematologist at Johns Hopkins and my professor back when I was a medical student, in a personal conversation.
I’m sure KG also has many such cites from his long career as an internist. But personally I consider medical information provided by him to be a cite in and of itself (unless I disagree with him, of course )
Fair enough. I didn’t know Karl was a sawbones.
I do consider most of what you say, QtM, to be a cite in and of itself.
Well, don’t stop asking for more info, including cites, if something doesn’t add up. The gods know I’ve been wrong before.