Trombosytopenian

Trombosytopenian, also called thrombocytopenia in English, is a condition characterized by an abnormally low platelet count in the peripheral blood. A platelet count below 150,000 per microliter defines thrombocytopenia, with bleeding risk increasing at lower levels; counts below about 20,000 per microliter carry a high risk of spontaneous bleeding.

Causes are diverse and typically categorized as decreased production, increased destruction or sequestration, and dilutional processes. Decreased production can result from bone marrow disorders (such as aplastic anemia or leukemia), nutritional deficiencies, or cytotoxic therapies. Increased destruction includes immune-mediated processes (immune thrombocytopenia), drug-induced thrombocytopenia, and infections; hypersplenism can sequester platelets in the spleen. Dilutional thrombocytopenia may occur after massive transfusion.

Symptoms range from none to mucocutaneous bleeding, such as petechiae, easy bruising, epistaxis, gum bleeding, and heavy menses. Diagnosis begins with a complete blood count and peripheral smear to confirm low platelets and assess morphology; additional tests target suspected causes and may include autoimmune studies, viral testing, and bone marrow examination when indicated.

Management is tailored to cause and severity. Mild cases without bleeding are often watched, while active bleeding or very low counts may require platelet transfusion. Immune-mediated thrombocytopenia is treated with steroids or intravenous immunoglobulin; refractory cases may respond to splenectomy or thrombopoietin receptor agonists. Eliminating causative drugs and treating underlying conditions are essential.

Prognosis varies with the underlying cause. Acute cases related to infection or drugs may resolve, whereas chronic thrombocytopenia due to bone marrow disease requires ongoing care.