Platelets are cells produced by the bone marrow that stop the bleeding by initiating clotting in the blood when blood vessels are damaged. Their amounts in the blood can be reduced or increased depending on different factors. When the number of thrombocytes (Platelets, T) is higher or lower than they should be, a number of problems and complications may occur. For example, its high level may cause a heart attack and cerebral palsy. Blood platelet count is usually measured by whole blood count (Hemogram) tests. According to the test results, doctors can initiate the treatment process.
What are platelets (PLT)?
Platelets (PLT or T) are small blood cells produced by
the bone marrow like red and white blood cells that prevent bleeding by
allowing blood clotting. These colorless blood cells stop bleeding by clumping
if blood vessels are injured. They are produced by cells called megakaryocytes
in the bone marrow. The smallest of our blood cells are platelets. They look
like a small plate under a microscope.
If one of
the blood vessels are damaged, the platelets receive the signal. After having
received the signal, platelets run to the site of injury, and initiate
clotting. First, they are interconnected where the damaged blood vessel is
located.
They then spread to the surface of the blood vessel and stop the bleeding. They come to the wounded area, adhere to it, and grow like a spider. During the clustering process, they send signals to others to increase aggregation.
What is platelet count?
The number
of platelets in the blood can be determined by the platelet count. PLT is
performed as a neighborhood of an entire blood count test (CBC). First, a
sufficient amount of blood is transferred to the tubes, and erythrocytes in the
blood are hemolyzed. The remaining platelets are then counted by optical
counters. Blood count must be done on an empty stomach. Some situations, such
as clustering, can cause test results to fail.
What is the normal platelet count?
The value of
platelets in healthy people, is between 150-450 thousands per microliter. Their
presence of more than 450 thousand in the blood is called thrombocytosis. It
is called thrombocytopenia under 150 thousand. When the platelet count falls
below 10-20 thousand, there's a risk of spontaneous bleeding. If the blood
vessel is damaged, its number is less than 50 thousand, which can lead to
extremely serious bleeding.
Low platelet
count (Thrombocytopenia)
Causes of thrombocytopenia
Low platelet
count is a condition in which the total number of platelets in the blood is
low. It may be mild or moderate. If untreated, it can have fatal consequences.
It usually develops due to leukemia or the use of certain drugs. It can happen
to everyone.
• Bone marrow problems
Bone marrow
is a spongy tissue in the bone, and produces blood components. The most
important cause of thrombocytopenia is the insufficient production of bone
marrow. Excess anemia, vitamin B12 deficiency, iron and folate deficiency,
cirrhosis, leukemia, heavy alcohol consumption, chemotherapy, exposure to
chemicals and radiation, HIV, chickenpox, viral infections and myelodysplasia
may lead to insufficient production of platelets by the bone marrow.
• Platelet destruction
Regular use
of certain drugs such as anti-seizure and diuretic drugs, etc. may lead to
platelet destruction. Spleen enlargement, pregnancy, a bacterial infection in
the blood, hemolytic uremic syndrome, autoimmune disorders such as rheumatoid
arthritis and thrombotic thrombocytopenic purpura are the most important
causes of platelet destruction.
Hemolytic
uremic syndrome: It is a rare disease that causes the destruction of red blood
cells, loss of function in the kidneys, and a decrease in the amount of platelets.
It resembles to E. coli infection that enters the body after consumption of raw
or undercooked meat.
• Spleen enlargement
The spleen
is an important organ that separates unwanted substances from the blood. Spleen
enlargement means that plenty of platelets is housed in the spleen. In this
case, the number of circulating blood is indirectly reduced.
• Thrombocytopenic purpura
It is a
disease accompanied by blood destruction and decreased blood platelets,
together with fever, renal failure, and some neurological effects. Drowsiness,
coma, partial paralysis may be observed. If the disease is not treated in time,
it is highly likely to cause death.
Symptoms of low platelets
• Red,
purple, brown bruises called purpura,
• Bleeding
gums,
• Nose
bleeding,
• Bleeding
in the rectum,
• Blood in
urine (a sign of internal bleeding)
• Blood in
the stool (a sign of internal bleeding)
• Severe
menstruation,
• Bleeding
in long-standing, non-healing wounds,
• Small,
red, purple rashes called Petechiae,
• Bloody or
very dark mucus (a sign of internal bleeding)
Mild cases,
such as pregnancy, do not cause serious symptoms. However, serious cases may
require urgent medical attention.
Is thrombocytopenia dangerous?
When the
platelet count falls below 10,000 per microliters, it can cause dangerous
internal bleeding. In cases of severe thrombocytopenia, however rarely,
cerebral hemorrhage may occur. If your platelet count is low, you should see a
doctor immediately when you experience headaches or any neurological problems.
How to raise platelets naturally?
Thrombocytes
can be elevated by limiting alcohol consumption, discontinuing the use of drugs
such as aspirin and ibuprofen, and avoiding contact sports and activities that
can cause high bleeding or bruising.
Treatment of low platelets
Treatment
may vary depending on the underlying cause of low platelets. First, the disease
that leads to a low level of platelets should be treated. In the case of a light
level, your doctor will monitor your condition and continue treatment. Medical
treatment may be mandatory in the severe case of low platelets.
Medical treatment of
thrombocytopenia
The method
of treatment may vary depending on the cause of thrombocytopenia. Depending on
the situation, one or more of the following treatments may be recommended:
•
Replacement of drugs leading to thrombocytopenia
•
Prescribing drugs such as steroids, corticosteroids, globulin, and so on.
• Surgical
removal of the spleen
• Blood or
platelet transfusion (red blood cells are transferred to the lost blood)
•
Prescription of immunosuppressive drugs
• Plasma
exchange (this method is used in the treatment of thrombocytopenic purpura)
Foods to increase platelets
Citrus
fruits rich in vitamin C, spinach, Indian Gooseberry, beets, papaya, Aloe Vera
gel, pumpkin, raspberries, lean protein sources rich in B12, foods rich in
vitamin A is among the platelet raising foods.
High platelets count
(Thrombocytosis)
Causes of thrombocytosis
Thrombocytosis
is a condition, which the body produces too much platelet. Infection-induced
ones are called secondary thrombocytosis. The absence of any cause behind
thrombocytosis is called primary thrombocythemia. This is usually caused by
blood or bone marrow disease.
What diseases cause thrombocytosis?
• Secondary
thrombocytosis
It is
related to an underlying problem. Autoimmune disorders such as cancer, iron
deficiency, hemolytic anemia, some infections, acute bleeding and blood loss,
surgical traumas, rheumatoid arthritis and so on., or inflammatory disorders
such as removal of the spleen, inflammatory bowel disease, etc. may lead to
secondary thrombocytosis.
• Primary
thrombocythemia
It is
usually caused by mutations in some genes. Platelets produced by the bone
marrow are usually abnormal. It can cause more serious blood clotting and
bleeding complications. According to the MPN Research Foundation, most patients
with primary thrombocythemia have a JAK2 gene mutation. It is more common in
women over the age of 50, but may also affect young people.
Symptoms of
high platelets
• Headache
• Dizziness
or loss of balance
• Chest Pain
• Fainting
• Temporary
vision changes
• Numbness
or tingling of hands and feet
• Redness,
throbbing and burning sensation in the hands and feet (erythromelalgia)
Symptoms
depend on where clots occur:
Sometimes patients
do not have any symptoms. The first sign of your disease may be a blood clot
formation (thrombus). These clots can develop anywhere in your body, but
primary thrombocythemia usually occurs in the brain, hands, and feet. Rarely, if
the blood count is too high (more than 1 million per microliter of blood),
primary thrombocythemia may cause bleeding as follows:
• Nosebleeds
• Bruising
• Bleeding
in your mouth or gums
• Bloody
stool
If blood
clots occur in the arteries supplying the brain, the blood flow to a part of
the brain is temporarily interrupted. This may also cause a transient ischemic
attack or stroke. The symptoms of transient ischemic attack or paralysis
develop suddenly and are:
• Weakness
or numbness on one side of your body, usually your face, arm or leg
• Difficulty
in speaking or understanding (aphasia)
• Blurred,
double or low vision
Is high platelets dangerous?
Patients
with primary thrombocythemia may experience transient erythema attacks and
paralysis due to high platelets. At the same time, these patients are at risk
of having a heart attack. People who experience heart attacks, strokes, or
severe bleeding should seek medical attention immediately.
Diagnosis of
high platelets
Your doctor
may check the size of your spleen or look for signs of infection. With the full
blood count test, he/she can detect whether the platelet amount in your blood
is higher than normal. He/she can also take tissue samples from your bone marrow
for further testing.
Treatment of high platelets
Treatment of
high primary or secondary platelets may vary.
Secondary thrombocytosis treatment
Treatment
depends on the cause of thrombocytosis. In the event of blood loss due to
surgery or injury, a large amount of coagulation dissolves on its own. The
problem is resolved by the treatment of the disease in the case of a chronic
discomfort or inflammatory disease-induced thrombocytosis.
If the
spleen is removed, you may have to live with a high platelet amount for the
rest of your life. However, no additional treatment is needed in this case.
Primary thrombocytosis treatment
Treatment is
determined depending on your risk of developing blood clots. Your doctor may
prefer only to monitor your condition if there are no symptoms or risks.
However, patients over 60 years of age who smoke, have diabetes or any
cardiovascular disease, and who have a history of bleeding or blood clotting
must be treated.
In this
case, low-dose aspirin is usually prescribed. Your doctor may also prescribe
certain medications that reduce clotting and slow down thrombsite production.
He/she can also prefer to remove excess platelets from your blood by a
procedure called platelet perineosis.
If you have
recently been diagnosed with primary thrombocythemia, you should first quit
smoking. Also, if you have a problem with cholesterol, diabetes or blood
pressure, you should exercise regularly and follow a diet of fruits,
vegetables, whole grains, and lean protein sources.
Foods that lower platelets
Omega-3 fatty acids, garlic, cumin, cloves, turmeric are among the most important foods that reduce the number of platelets in the blood
Platelet donation
Platelet
donation can be performed by anyone in the 18-60 age range. The donation takes
approximately 1.5 hours, and has no side effects. The platelet donor must weigh
at least 50 kg. The number of platelets should be over 150 thousand. All
requirements that are asked for a typical blood donation also apply to platelet
donation.
The patient
should be in good health, and the vascular structure should be appropriate for
donation. While the blood groups of the platelet donor and recipient should be
the same as a first priority, people who have a different blood group than the
recipient may also donate. The platelet donor should discontinue the use of
aspirin and aspirin derivatives at least 48 hours before the procedure.
Platelet apheresis can be performed at least 4 weeks after whole blood
donation. The patient can donate whole blood at least 48 hours after the
apheresis procedure. Sets used during platelet donation are disposable.