This reference summary explains platelet disorders. It covers symptoms of these disorders as well as treatment options.

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1 Platelet Disorders Introduction Platelets are little pieces of blood cells that help wounds heal. They prevent severe bleeding by forming blood clots. Having too few platelets, too many platelets or platelets that do not work properly can lead to health problems. Treatment of platelet disorders depends on the cause. It may include medicines, transfusions and other therapies. This reference summary explains platelet disorders. It covers symptoms of these disorders as well as treatment options. Platelets and Blood Blood is made of blood cells that float in plasma. Plasma is mostly made of water, antibodies and other proteins. Antibodies are proteins that are found in the blood. They fight bacteria, viruses and other foreign substances. There are 3 basic types of blood cells: Red blood cells. White blood cells. Platelets. Red Blood Cells White Blood Cells Red blood cells, or RBCs, make up almost half of the volume of blood. White blood cells, or WBCs, fight disease and infection by attacking and killing germs that get into the body. Platelets are small pieces of blood cells that help wounds heal. They prevent bleeding by forming blood clots. Symptoms Many platelet disorders have similar symptoms. The main symptoms of platelet disorders are excessive bruising, bleeding and blood clots. Platelets 1

2 Other common symptoms of platelet disorders are: A fast heart rate. Feeling weak and tired. Fever. Headache. Shortness of breath. Other common symptoms of platelet disorders include: Confusion. Paleness. Speech changes. Seizures. Yellow-colored skin. Some platelet disorders may also cause: Blood in urine or stools. Nausea or vomiting. Nosebleeds or bleeding gums. Pinpoint-sized red or purple dots on the skin, called petechiae. Purplish bruises on the skin, called purpura. Talk to your health care provider if you notice any of these symptoms or other changes. Finding a problem early makes treatment easier in most cases. Low Number of Platelets If your blood has a low number of platelets, you can be at risk for mild to serious bleeding. Sometimes these types of platelet disorders are also called bleeding disorders. Types of bleeding disorders include: Idiopathic thrombocytopenic purpura, or ITP. Thrombotic thrombocytopenic purpura, or TTP. Hemolytic uremic syndrome, or HUS. In ITP, the body's immune system mistakenly attacks platelets. The immune system identifies platelets as a threat. The body then creates antibodies that attack the platelets and destroy them. ITP causes a low number of platelets. This leads to excessive bruising and bleeding. The cause of ITP is not known. 2

3 TTP is a rare condition that happens when small blood clots suddenly form throughout the body. The blood clots use up a large number of platelets, resulting in a low platelet count. People who have TTP may bleed inside their bodies, underneath the skin or from the surface of the skin. People with TTP also may bleed longer than normal when they are cut or injured. TTP may be triggered by: Certain medicines, such as chemotherapy or hormone therapy. Medical procedures, such as surgery. Some diseases and conditions, such as cancer or pregnancy. HUS is a rare disorder that causes a sharp drop in platelets and the destruction of red blood cells. It can happen along with a bacterial E. coli infection, which may be caused by eating raw or undercooked meat. HUS can cause life threatening kidney failure. This results from damaged red blood cells clogging the kidneys. Most cases of HUS happen in children after 2 to 14 days of diarrhea caused by an E. coli infection. Adults can also get HUS after an E. coli infection. Other possible causes of HUS in adults include: Having other types of infections. Pregnancy. Taking certain medicines. In some cases, the cause of HUS may be unknown. Treatment for a low blood platelet count and bleeding disorders depends on the cause. Treatment may include: Medicines. Transfusions. Surgery. 3

4 Medicines may be given to decrease the activity of the immune system. Medicines may also be used to increase platelet count by helping the bone marrow make more platelets. Transfusions of plasma, platelets or red blood cells may also help. Transfusions use an IV line to deliver donated red blood cells or platelets. In some cases, surgery may be done to remove the spleen. The spleen contributes to the destruction of platelets, and this surgery removes a source of platelet destruction in some people. High Number of Platelets If your blood has too many platelets, you may have a higher risk of blood clots. Blood clots may cause complications such as the loss of a limb, strokes and death. Thrombocythemia and thrombocytosis are conditions in which your blood has a higher than normal number of platelets. The term thrombocythemia is used when the cause of a high platelet count is not known. When another disease or condition causes a high platelet count, the term thrombocytosis is used. Thrombocytosis is more common than thrombocythemia. Thrombocytosis may be caused by: Anemia, or low red blood cells. Certain types of cancer, including lung cancer and breast cancer. Removal of the spleen. Anemia happens when the blood does not carry enough oxygen to the rest of the body. The most common cause of anemia is not having enough iron. Thrombocytosis may also be caused by: Inflammatory or infectious diseases, such as connective tissue disorders or tuberculosis. Reactions to medicine. Tuberculosis is a disease caused by a specific type of bacteria. The bacteria usually attack the lungs. But they can also damage other parts of the body. 4

5 Some conditions can lead to a high platelet count that lasts for only a short time. Examples of such conditions include: Recovery from the loss of a large amount of blood. Response to physical activity. Short-term infection or inflammation. People with thrombocythemia who have no signs or symptoms may not need treatment. If treatment is needed, the goal is to lower platelet counts. Thrombocytosis is treated by addressing the condition that's causing it. People who have thrombocytosis usually don't need platelet-lowering medicines or procedures. This is because their platelets are often normal. Other Platelet Disorders With other platelet disorders, the platelets do not work as they should. For example, in von Willebrand disease, or VWD, the platelets cannot stick together or attach to blood vessel walls. This can cause severe bleeding. In VWD, you either have low levels of a certain protein in your blood, or the protein does not work well. VWD is the most common inherited bleeding disorder. It affects both males and females. Most cases of VWD are mild. You may need treatment only if you have surgery or an accident. Treatment usually involves medication. Hemophilia is a rare bleeding disorder in which the blood does not clot normally. It can be mild, moderate or severe. People born with hemophilia have little or no clotting factor. Hemophilia is often inherited. It is most often found in males. Females may also inherit the disorder in rare cases. There are 2 main types of hemophilia: type A and type B. Different clotting factors are low or missing in each type of hemophilia. About 90% of people with hemophilia have type A. Rarely, hemophilia can be acquired. It can be acquired if your body forms antibodies that attack the clotting factors in your bloodstream. The antibodies can prevent the clotting factors from working. 5

6 The main treatment for hemophilia is replacement therapy. Replacement therapy gives you the clotting factor that you are missing. Concentrates of clotting factor are given through an IV drip or an injection into a vein. Medicines, steroids and other treatments also may be used. These are often used to treat a specific area of the body that is bleeding. Summary Platelets are little pieces of blood cells that help wounds heal. They prevent bleeding by forming blood clots. Having too few platelets, too many platelets or platelets that do not work properly can lead to health problems. Many platelet disorders have similar symptoms. The main symptoms are excessive bruising, bleeding and blood clots. Other common symptoms are: A fast heart rate or shortness of breath. Feeling weak and tired. Fever. Headache, speech changes, confusion or seizures. Paleness or yellow-colored skin. Talk to your health care provider if you notice any of these symptoms or other changes. Finding a problem early makes treatment easier in most cases. If your blood has a low number of platelets, you can be at risk for mild to serious bleeding. Sometimes these types of platelet disorders are also called bleeding disorders. If your blood has too many platelets, you may have a higher risk of blood clots. Complications of blood clots may include the loss of a limb, strokes and death. With other platelet disorders, the platelets do not work as they should. For example, in von Willebrand disease, or VWD, the platelets cannot stick together or attach to blood vessel walls. This can cause excessive bleeding. Treatment of platelet disorders depends on the cause. It may include medicines, transfusions and other therapies. Talk to your health care provider to learn more about platelet disorders and their treatments. 6

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