Trombotsütopeeniaks

Trombotsütopeeniaks (thrombocytopenia) is a condition defined by a lower-than-normal platelet count in the blood, typically below 150,000 platelets per microliter. Platelets are essential for normal blood clotting, and reduced numbers increase the risk of bruising and abnormal bleeding.

Causes are diverse and commonly grouped as decreased production in the bone marrow (for example, aplastic anemia, leukemia, chemotherapy, or nutritional deficiencies), increased destruction or consumption (immune thrombocytopenia, drug-induced thrombocytopenia, heparin-induced thrombocytopenia), splenic sequestration in hypersplenism, or dilution after massive transfusion.

Clinical presentation ranges from none to symptomatic bleeding, with easy bruising, petechiae, nosebleeds, or heavy menses. Diagnosis starts with a complete blood count showing low platelets and a peripheral smear to assess platelet size and exclude clumping. Pseudothrombocytopenia caused by EDTA-related platelet clumping should be ruled out by repeating testing with citrate or heparin. Further workup targets suspected etiologies, including viral infections, autoimmune markers, HIV, hepatitis C, pregnancy, and medication history; bone marrow examination may be needed if cytopenias persist or other clues arise.

Management depends on cause, severity, and bleeding risk. Mild thrombocytopenia without bleeding is often observed. Immune thrombocytopenia may respond to corticosteroids, intravenous immunoglobulin, or anti-D immunoglobulin, with splenectomy or thrombopoietin receptor agonists as possible options. Drug-induced cases require stopping the offending agent. Life-threatening bleeding may necessitate platelet transfusions and supportive care. Pregnancy requires careful, pregnancy-specific management to balance maternal and fetal risks.

Prognosis varies with cause; many cases improve with treatment of the underlying disease, while some become chronic. Ongoing research continues to optimize risk assessment and targeted therapies.