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Thrombocytopenia

Thrombocytopenia
Synonyms thrombopenia
A picture of the blood under a microscope showing thrombocytopenia
A picture of the blood under a microscope showing thrombocytopenia
Classification and external resources
ICD-10 D69.6
ICD-9-CM 287.5
Patient UK Thrombocytopenia
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Thrombocytopenia refer to a disorder in which there is a relative decrease of thrombocytes, commonly known as platelets, present in the blood.

A normal human platelet count ranges from 150,000 to 450,000 platelets per microliter of blood. These limits are determined by the 2.5th lower and upper percentile, so values outside this range do not necessarily indicate disease. One common definition of thrombocytopenia that requires emergency treatment is a platelet count below 50,000 per microliter.

Thrombocytopenia usually has no symptoms and is picked up on a routine full blood count (or complete blood count). Some individuals with thrombocytopenia may experience external bleeding such as nosebleeds, and/or bleeding gums. Some women may have heavier or longer periods or breakthrough bleeding. Bruising, particularly purpura in the forearms, may be caused by spontaneous bleeding under the skin. Petechia (pinpoint bleeds in the skin and mucous membranes), may occur on feet and legs.

Eliciting a full medical history is vital to ensure the low platelet count is not due to a secondary process. It is also important to ensure that the other blood cell types, such as red blood cells and white blood cells, are not also suppressed. Painless, round and pinpoint (1 to 3 mm in diameter) petechiae usually appear and fade, and sometimes group to form ecchymoses. Larger than petechiae, ecchymoses are purple, blue or yellow-green areas of skin that vary in size and shape. They can occur anywhere on the body.

A person with this disease may also complain of malaise, fatigue and general weakness (with or without accompanying blood loss). In acquired thrombocytopenia, the patient's history may include the use of one or several offending drugs. Inspection typically reveals evidence of bleeding (petechiae or ecchymoses), along with slow, continuous bleeding from any injuries or wounds. Adults may have large, blood-filled bullae in the mouth. If the person's platelet count is between 30,000 and 50,000/mm3, bruising with minor trauma may be expected; if it is between 15,000 and 30,000/mm3, spontaneous bruising will be seen (mostly on the arms and legs).


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