Expert answer:
THE platelet count (platelets below 150,000 / mm3) can have several causes:
- diseases that lead to a decrease in the production of platelets in the bone marrow: medullary aplasia, fibrosis or infiltration by malignant cells (visceral or hematological cancer, such as lymphomas and leukemias), chemotherapy. The diagnosis is made through bone marrow biopsy.
- diseases that occur with enlargement of the spleen (splenomegaly), with sequestration and destruction of platelets: portal hypertension (may occur in hepatic cirrhosis, schistosomiasis, portal vein thrombosis); infiltration of tumor cells into the spleen, leukemias and lymphomas, and Gaucher disease.
- increased platelet destruction, due to the presence of abnormal vessels, vascular prostheses and thrombi, which occur in the following diseases: thrombotic thrombocytopenic purpura, vasculitis, hemolytic-uremic syndrome, disseminated intravascular coagulation and cardiac prostheses.
side effect of medicines:
- thiazide diuretics, estrogens and myelosuppressive drugs induce decreased platelet production in the bone marrow.
- sedatives, hypnotics, anticonvulsants, alpha-methyldopa, gold salts and heparin can induce immune destruction of platelets.
- infectious diseases, such as dengue, AIDS, hepatitis C, spotted fever, leptospirosis, yellow fever and severe septicemia.
- immunological diseases, in which blood platelets (intravascular) are destroyed, such as immune thrombocytopenic purpura and some rheumatic diseases, such as systemic lupus erythematosus.
It is important to emphasize that there are diseases in which platelets are at normal levels, but their function is deficient, as in chronic renal failure with uremia, for example.
In the case of thrombocytopenia without hemorrhagic symptoms, a hematologist should be sought for appropriate diagnosis and treatment. If hemorrhagic manifestations occur, prompt care should be sought.
