Thrombocytopathy: Causes, Symptoms & Treatment

Platelets – also called blood platelets – perform an important task in the human body. They regulate blood clotting and ensure that wounds do not continually bleed, thus preventing blood loss. There are different diseases that influence the properties or the number of platelets. These are grouped under the term thrombocytopathy.

What is thrombocytopathy?

Plateletopathy is the term scientists use to describe any medical condition that causes platelets to malfunction. This means the platelets cannot perform their normal function – helping blood clot – as usual. As a result, bleeding is no longer stopped as quickly, but lasts longer. In addition, bleeding occurs more frequently. The number of platelets remains unchanged. There are two forms of thrombocytopathy: the inherited and the acquired form. Most diagnosed thrombocytopathies are the acquired form. Inherited thrombocytopathies are due to various syndromes. Known syndromes include Bernard-Soulier syndrome or Willebrand-Jürgens syndrome. Another rare disorder is Glanzmann thrombocytopenia. All syndromes have in common that they result in a genetic defect that prevents platelets from performing their natural function.

Causes

The causes of acquired thrombocytopathy are varied. For example, they occur when the immune system is weakened by an infection. When the kidneys are impaired, for example in renal failure, platelet dysfunction may be a concomitant disease. Liver disease can also lead to such a clinical picture. In addition, patients suffering from leukemia are sometimes affected by thrombocytopathy. Very often, the functional disorder occurs in connection with the use of medications. Painkillers (for example, aspirin) and anti-inflammatory drugs such as diclofenac are particularly worthy of mention here. Certain antibiotics, such as penicillin, have also been identified as a cause. The influence due to medications is considerable. Physicians must take this into account in upcoming operations. For here, poorly functioning blood clotting can have fatal consequences. Therefore, such substances must be discontinued for a sufficient period of time before the planned surgery.

Symptoms, complaints and signs

The clinical picture of thrombocytopathy exhibits various symptoms. Very often, patients suffer from increased nosebleeds. Gum bleeding is also a typical feature. Internal bleeding, for example of the gastrointestinal tract, which manifests itself as blood in the stool, can also be an indication. People who discover an above-average number of hematomas (bruises) on their body should also consult a doctor. In women, thrombocytopathy is indicated by unusually prolonged menstruation. After minor surgical procedures or the extraction of a tooth, prolonged bleeding afterward may be a sign of the clotting disorder.

Diagnosis and course of the disease

If one or more of the previously described symptoms occur, a physician should be consulted. Several aspects must be considered when making a diagnosis. First, a general questioning of the patient takes place. Here, the physician is interested in bleeding events that have occurred as well as corresponding occurrences in relatives. After this anamnesis, the physician asks questions about possible drug consumption, since, as already described, this is the main cause of thrombocytopathy. If the suspicion of a disease is confirmed, the physician determines the clotting time by a so-called search test. Here he determines the time to clotting after a light cut. A final laboratory test provides the final confirmation for a confirmed diagnosis.

Complications

In thrombocytopathy, affected individuals suffer from a number of different complaints. First and foremost, a nosebleed is very common in this condition. This complaint can have a very negative impact on the daily life and quality of life of the affected person, significantly limiting it. Bleeding from the gums also occurs frequently and can lead to infections of the gums. Patients also suffer from stomach or intestinal complaints, so that bloody bowel movements may also occur.On the skin, a high number of bruises or hemorrhages occur due to thrombocytopathy. In women, the disease can also cause prolonged menstrual bleeding. Minor wounds or cuts also bleed longer and the patient’s wound healing is significantly delayed. Thrombocytopathy can usually be controlled relatively easily with the help of medication. No particular complications occur. However, this treatment must be given throughout the patient’s life. The risks of bleeding must also be better assessed during surgical procedures. As a rule, there is no reduction in the patient’s life expectancy with this condition.

When should one go to the doctor?

If human bleeding cannot be stopped or is very difficult to stop, a physician should be consulted immediately. If large amounts of blood are lost from even small wounds, this is considered unusual and a sign of a health disorder. A doctor is needed because a life-threatening condition is imminent if the disease progresses unfavorably. If bleeding cannot be stopped, there is a risk of bleeding to death even from cuts. Frequent nosebleeds or bleeding gums are indications of a disease. If bruising or hematomas form even when slight pressure is applied to the skin, a doctor should be consulted. Discoloration of the skin, unusual pallor, and low resilience should be presented to a physician. If sexually mature girls or women have a very heavy menstrual period with enormous blood loss, a doctor must be consulted. If bleeding causes dizziness, malaise, an internal weakness or a loss of physical strength, clarification of the cause is recommended. General dysfunction, a loss of blood when going to the toilet, as well as faintness and exhaustion are other complaints that need to be investigated. In the case of headaches, irregularities in memory, sleep disturbances and palpitations, clarification of the cause is recommended. Medical examinations are needed so that a diagnosis can be made and a treatment plan can be established.

Treatment and therapy

In order to treat thrombocytopathy, the cause must be identified first and foremost. If the disease is due to the use of medications, discontinuation of these occurs – if possible. To further treat the causative disease, the physician will prescribe an alternative drug. If the coagulation disorder is to be actively combated, the administration of so-called DDAVP (1-desamino-8-D-arginine vasopressin) substances is an option. These help to restore the natural function of the blood platelets. The usual form of administration is a nasal spray or an infusion. The physician determines whether treatment with the substance has been successful through test applications. In an emergency, affected patients receive a transfusion. This may be necessary as part of an operation if an existing thrombocytopathy was not previously diagnosed. In this case, platelets from a healthy donor are introduced into the bloodstream of the sick person. One risk here is that the recipient may not tolerate the transfusion and rejection of the administered platelets may occur.

Prevention

If a blood clotting disorder is sufficiently known before an upcoming procedure, preventive measures should be taken. In addition to discontinuing the causative drugs as described, the treating physician can administer the hormone desmopressin. This causes the platelets to adhere better to the injured site and thus accelerates the clotting process again. Depending on the type of procedure, the physician has the choice of administering it as a nasal spray (for example, in the case of a tooth extraction) or via the vein (in the case of surgery). Children and adolescents who have the congenital variant of thrombocytopathy also receive numerous preventive measures to avoid worsening of the condition. These include regular administration of platelet concentrates, which take over the function of impaired platelets. In addition, affected children are given special medications that lead to increased formation of clotting factors. Girls suffering from the disease take supportive hormones during menstruation. Since liver diseases are a cause of the clotting disorder, vaccination against hepatitis A and hepatitis B is advisable.

Aftercare

In most cases, the options for direct aftercare for thrombocytopathy are significantly limited or, in some cases, not even available to the affected person. Therefore, they should seek medical attention at the first signs and symptoms of this disease, while also initiating treatment to prevent complications or other ailments down the road. The earlier thrombocytopathy is recognized and treated by a doctor, the better the further course of this disease usually is. Most of those affected are dependent on taking various medications. This limits and also significantly alleviates the symptoms. Care must be taken to ensure that the dosage is correct and that the medication is taken regularly. In case of questions or side effects, a doctor should always be consulted first. Furthermore, regular checks and examinations should be carried out by a doctor. Frequently, those affected by thrombocytopathy are dependent on lifelong therapy to counteract the symptoms. However, the life expectancy of the affected person is not limited by the disease. In some cases, contact with other sufferers of the disease is also useful, as this can lead to an exchange of information.

What you can do yourself

Thrombocytopathy is treated only when physical symptoms are present. Platelet dysfunction does not usually result in health problems. Self-help measures are limited to watching for unusual symptoms after diagnosis that may indicate disease. The physician must be informed of these symptoms. If no health problems occur, a general practitioner or an internist should be consulted regularly. Regular measurement of blood values is indicated to check for platelet dysfunction and, at the same time, to detect any secondary physical symptoms. If any health problems are detected, drug treatment, such as desmopressin, is usually given. The patient can support the treatment by taking it easy and maintaining a healthy lifestyle. In addition, attention must be paid to any side effects and interactions of the drug treatment. The doctor must be informed of any side effects so that the necessary measures, usually a change in medication, can be initiated quickly. Further self-help measures are usually not necessary in the case of thrombocytopathy. Therefore, platelet dysfunction should mainly be treated preventively by discontinuing triggering drugs such as diclofenac or penicillin.