acquired thrombocytopenia

Acquired Thrombocytopenia: A Condition Where Platelet Count Drops

Acquired thrombocytopenia, also known as secondary thrombocytopenia, is a condition where the platelet count in the blood drops due to factors that develop after birth. This type of thrombocytopenia is not inherited from parents but rather develops later in life.

Causes and Risk Factors

Acquired thrombocytopenia can occur due to various reasons such as:

• Certain medications, chemotherapy, or radiation therapy
• Infections, poor nutrition, or inherited genetic conditions that affect the bone marrow's ability to produce platelets
• Blood cancers like leukemia or lymphoma that damage the bone marrow and affect its ability to make enough blood cells, including platelets
• Autoimmune diseases such as immune thrombocytopenia (ITP), lupus, or rheumatoid arthritis that attack the immune system and destroy platelets

Symptoms

People with acquired thrombocytopenia may experience excessive bleeding due to low platelet count. The risk of bleeding increases as the platelet count decreases.

Treatment Options

Treatment for acquired thrombocytopenia depends on the underlying cause. In some cases, doctors can prescribe different blood-thinning medications or transfusions of packed red blood cells or platelets to replace lost blood. Other treatments may involve medications to manage symptoms and prevent complications.

References:

• [1] Thrombocytopenia is a condition in which you have a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that help blood clot.
• [2] Acquired thrombocytopenia is caused by conditions that develop throughout your life instead of genes inherited from birth.
• [4] Thrombocytopenia can occur because the bone marrow doesn’t produce enough platelets, and there are different reasons for this. Certain medications, chemotherapy (medication to treat cancer), radiation therapy, infections, poor nutrition, or inherited genetic conditions can cause the bone marrow to stop making platelets
• [11] Specific factors affecting platelet supply include: Autoimmune diseases: Autoimmune diseases, like immune thrombocytopenia (ITP), lupus and rheumatoid arthritis, that attack your immune system may destroy platelets.
• [14] For example, if you have heparin-induced thrombocytopenia, your doctor can prescribe a different blood-thinning drug. Other treatments might involve: Blood or platelet transfusions. If your platelet level becomes too low, your doctor can replace lost blood with transfusions of packed red blood cells or platelets. Medications.

Easy or excessive bruising (purpura) is one of the common signs of acquired thrombocytopenia, where the platelet count is low due to various reasons such as infections, medications, or inherited conditions [1]. This condition can also cause superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs [1].

In addition to these symptoms, people with acquired thrombocytopenia may experience prolonged bleeding from cuts and bleeding from their gums or nose. It's worth noting that if the platelet count is only slightly low, symptoms might not be noticeable at all [2].

Mild thrombocytopenia often has no symptoms, but when signs of bleeding do appear, they can include bleeding that lasts a long time, even from small injuries [3]. This condition can occur in varying degrees, and the risk of bleeding increases as the platelet count decreases.

In some cases, acquired thrombocytopenia may cause more severe symptoms such as purple bruises or tiny red or purple spots on the skin, bleeding problems, anemia, and other complications [8]. It's essential to seek medical care if you notice any changes in your body that could be related to thrombocytopenia, such as new bruises and unusual bleeding.

References: [1] - Context result 1 [2] - Context result 2 [3] - Context result 3 [8] - Context result 8

Acquired thrombocytopenia, also known as low platelet count, can be diagnosed through various laboratory tests and medical evaluations.

Initial Laboratory Tests

• A complete blood count (CBC) is typically the first test performed to diagnose thrombocytopenia. This test measures the number of red blood cells, white blood cells, and platelets in a sample of your blood [3].
• A peripheral blood smear can provide important clues about the underlying cause of thrombocytopenia [7].

Additional Tests

• Blood tests will show a low platelet count if you have thrombocytopenia. Your doctor may also perform other tests to investigate the cause of your condition [4].
• Platelet function tests check your platelets' ability to form clots, which can help identify the underlying cause of thrombocytopenia [8].

Imaging Tests

• Imaging tests such as ultrasound or CT scans may be ordered to rule out other conditions that could be causing your symptoms.

Bone Marrow Tests

• Bone marrow tests may be performed in some cases to evaluate the production and function of platelets in the bone marrow.

It's essential to note that a correct identification of the causes of thrombocytopenia is crucial for the appropriate management of these patients [11]. A systematic evaluation of adults with thrombocytopenia can help healthcare professionals choose and interpret diagnostic tests effectively, guide treatment strategies, and optimize patient outcomes [15].

References: [3] - Aug 12, 2024 — Initial and essential laboratory tests in all cases include a CBC and a peripheral blood smear... [7] - by RL GAUER · 2012 · Cited by 229 — A peripheral blood smear can provide diagnostic information on a variety of white blood cell disorders, hemolytic anemias, and thrombocytopenia... [4] - If you have thrombocytopenia, blood tests will show a low platelet count. You may have other tests to investigate the cause of your thrombocytopenia. [8] - Aug 15, 2024 — A platelet count test measures the number of platelets in your blood. Platelet function tests check your platelets' ability to form clots. [11] - A correct identification of the causes of thrombocytopenia is crucial for the appropriate management of these patients. [15] - Various routine screenings and specialized laboratory tests are available as diagnostic tools...

Acquired thrombocytopenia, also known as immune thrombocytopenia (ITP), is a condition characterized by a low platelet count resulting from platelet destruction and impaired platelet production. The current standard of care for treating acquired thrombocytopenia involves a combination of therapeutic plasma exchange, immunosuppression, and caplacizumab, an anti-von Willebrand factor nanobody.

Therapeutic Plasma Exchange

Plasma exchange is the therapy of choice for TTP (Thrombotic Thrombocytopenic Purpura), a condition closely related to acquired thrombocytopenia. This treatment involves exchanging the patient's plasma with fresh frozen plasma, which helps to remove autoantibodies and other harmful substances from the blood.

Immunosuppression

Immunosuppressive medications are often used in conjunction with plasma exchange to reduce the production of autoantibodies that destroy platelets. These medications can include corticosteroids, such as prednisone, and other immunosuppressants like rituximab.

Caplacizumab

Caplacizumab is a monoclonal antibody that targets von Willebrand factor, a protein involved in blood clotting. By binding to this protein, caplacizumab can help to prevent platelet activation and aggregation, which can contribute to the development of thrombocytopenia.

Other Medications

In addition to these treatments, other medications may be used to manage acquired thrombocytopenia. These can include glucocorticoids, such as prednisone, and other immunosuppressants like cyclophosphamide. In severe cases, a splenectomy (removal of the spleen) may be necessary.

References

• Current standard of care is therapeutic plasma exchange, immunosuppression, and caplacizumab, an anti-von Willebrand factor nanobody [1].
• Plasma exchange with fresh frozen plasma is the therapy of choice for TTP [8].
• Caplacizumab reduces the frequency of major thromboembolic events, exacerbations, and death in patients with acquired thrombotic thrombocytopenic purpura (TTP) [4].
• Corticosteroids may be used to treat ITP, especially in elderly patients (>60 years old) [13].

Differential Diagnosis of Acquired Thrombocytopenia

Acquired thrombocytopenia refers to a condition where the platelet count in the blood falls below the normal range, and it is not caused by a genetic mutation. The differential diagnosis of acquired thrombocytopenia involves identifying the underlying cause of this condition.

Possible Causes:

• Immune Thrombocytopenic Purpura (ITP): ITP is an autoimmune disorder where the immune system produces antibodies against platelets, leading to their destruction. This is one of the most common causes of acquired thrombocytopenia in adults.
• Differential Diagnosis: The differential diagnosis for a patient with new thrombocytopenia includes primary bone marrow disorders, chronic liver disease, infection, drug-related adverse effects, occult malignancy, and autoimmune/rheumatologic conditions [11].
• Bone Marrow Insufficiency: Bone marrow insufficiency can result in impaired platelet production, leading to thrombocytopenia. This can be caused by infiltrating tumor cells or a myelodysplastic syndrome.
• **Splenomegaly