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Low platelet count in the blood

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Low platelet count in the blood
Last update: 24/03/2021

What is a low count of platelets in the blood called?

  • Thrombocytopenia

What is the normal count of platelets in the blood?

If you need to know which are the platelets reference ranges or you require more information about the role of platelets in the blood, you can visit normal platelet count in the blood

What does a low count of platelets in the blood mean?

A low platelet count in the blood is called thrombocytopenia.

The main causes for thrombocytopenia are:

  • Low platelet production: Aplastic anemia, congenital disorders, medication, etc.
  • Increase consumption of platelets: Immune thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), disseminated intravascular coagulation.
  • Platelet storage in the spleen storage: Hypersplenism.

The most evident sign of thrombocytopenia is bleeding from the nose, mouth or rectum for no apparent reason. Prolonged bleeding and in women menstruation of more than three days or intermenstrual bleeding are also signs of a low platelet count.

A low platelet count is therefore a matter for concern because internal or external bleeding can lead to health complications.

Thrombocytopenia or a low platelet count in the blood means:

  • Mild thrombocytopenia (75 - 150 x 103/µl in adults):

    A mild thrombocytopenia is not usually a matter for concern.

    The platelet count may be affected by many variables, physiological or by the measurement process. If you do not have any symptom related to thrombocytopenia, you can take a blood test again in one or two weeks to know if platelet count returns to normal range.

  • Moderate thrombocytopenia (50 - 75 x 103/µl in adults):

    A moderate thrombocytopenia needs medical surveillance to prevent further decline. People suffering moderate thrombocytopenia may notice red or purple discolored spots on the skin called purpura.

    Viral infection with fever, including childhood viruses, mononucleosis, and dengue, usually have a platelet count around 100 x 103/µl and do not usually go below 50 x 103/µl.

    Disseminated intravascular coagulation is also often in the range of 50 to 100 x 103/µl.

  • Marked thrombocytopenia (25 - 50 x 103/µl in adults):

    A marked thrombocytopenia requires immediate medical attention. You may notice unexpected bleedings.

    It may due to ITP (idiopathic thrombocytopenic purpura) or secondary to lupus, HIV, hepatitis C or Helicobacter pylori. In case of suffering these diseases the platelet count may be around 10 to 80 x 103/µl.

    There are also some rare genetic disorders with a marked thrombocytopenia, such as Bernard Soulier syndrome with a platelet count between 30 and 60 x 103/µl and with a high MPV (Mean Platelet Volume).

  • Severe thrombocytopenia (< 25 x 103/µl in adults):

    A severe thrombocytopenia requires urgent medical attention. It may be due to a sudden acute disorder that increases dramatically platelet destruction (virus, drugs, acute ITP, etc.).

    Below 20 x 103/µl you may notice unexpected bleedings, for example, bleeding from the nose or rectal bleeding. They are a matter for concern and it may require a platelet transfusion.

    If the platelet count falls below 6 x 103/µl the bleeding will be so intense that it may lead to serious health problems.

Which factors can decrease the platelet count in the blood?

Some particular health situation and many drugs may reduce your platelet count in the blood:

  • Alcohol
  • Folate deficiency
  • Pregnancy
  • Chemotherapy
  • Radiation therapy
  • Blood transfusion
  • Drugs
    • Abciximab
    • Antiarrhythmic agents
      • Quinidine
    • Antibiotics
      • Vancomycin
    • Antineoplastics
      • Asparaginase
      • Azathioprine
      • Chlorambucil
      • Dacarbazine
      • Doxorubicin
      • Chlormethine
      • Mercaptopurine
      • Procarbazine
      • Vinblastine
    • Anticoagulants
      • Heparin
    • Antiepileptic drugs
      • Valproate
      • Carbamazepine
      • Phenytoin
    • Antimalarial medication
      • Quinine
    • Antituberculars
      • Rifampicin
    • Methotrexate
    • Thiazides

Which diseases can decrease your platelet count in the blood?

The following diseases can explain a platelet count in the blood lower than normal:

  • Thrombotic thrombocytopenic purpura
  • Immune thrombocytopenia purpura
  • Disseminated intravascular coagulation
  • Aplastic anemia
  • Hemolytic-uremic syndrome
  • Pre-eclampsia
  • Hepatic cirrhosis
  • Schistosomiasis
  • Malaria
  • Kala-azar
  • Antiphospholipid antibody syndrome
  • Hypersplenism
  • Neuroblastoma
  • Bernard–Soulier syndrome
  • Wiskott–Aldrich syndrome
  • Evans syndrome
  • Kasabach-Merritt syndrome
  • Chediak–Higashi syndrome
  • TAR syndrome
  • HELLP syndrome
  • Von Willebrand disease
  • Glanzmann's thrombasthenia
  • May-Hegglin anomaly
  • Congenital amegacariocytic thrombocytopenia
  • Rubella
  • Varicella
  • Mumps
  • Parvovirus infection
  • Cytomegalovirus
  • Mononucleosis
  • Dengue
  • Lupus
  • Hepatitis
  • HIV Human immunodeficiency virus
  • Fanconi syndrome
  • Megaloblastic anemia
  • Leukemia
  • Multiple myeloma

What can I do to increase the platelet count in the blood?

Excessive alcohol intake may reduce platelet production by the bone marrow. If this is the cause and you reduce the alcohol consumption you can recover the normal range in a few weeks.

Some foods may help to increase platelet count such as papaya, spinach or pumpkin.

You should avoid some non-alcohol drinks such as tonic water because it contains quinine and may reduce platelet count in the blood.

In case that the decrease in platelet count is due to folic acid deficiency, you can take green leafy vegetables or legumes.

Where can I find more information about platelet count in the blood?

You can visit our pages about:

Which values are considered a low platelet count in the blood?

The following values are considered to be above the normal range:

IMPORTANT: These levels are expressed in number of thousands/µl (microliter). They are an example of a healthy white man/woman of about 45 years old with no known disease and not taking any medication. The ranges can be different depending on the laboratory or on your personal circumstances.

Platelets
Mild thrombocytopenia
149 x 103/µl148 x 103/µl147 x 103/µl146 x 103/µl145 x 103/µl144 x 103/µl143 x 103/µl142 x 103/µl
141 x 103/µl140 x 103/µl139 x 103/µl138 x 103/µl137 x 103/µl136 x 103/µl135 x 103/µl134 x 103/µl
133 x 103/µl132 x 103/µl131 x 103/µl130 x 103/µl129 x 103/µl128 x 103/µl127 x 103/µl126 x 103/µl
125 x 103/µl124 x 103/µl123 x 103/µl122 x 103/µl121 x 103/µl120 x 103/µl119 x 103/µl118 x 103/µl
117 x 103/µl116 x 103/µl115 x 103/µl114 x 103/µl113 x 103/µl112 x 103/µl111 x 103/µl110 x 103/µl
109 x 103/µl108 x 103/µl107 x 103/µl106 x 103/µl105 x 103/µl104 x 103/µl103 x 103/µl102 x 103/µl
101 x 103/µl100 x 103/µl99 x 103/µl98 x 103/µl97 x 103/µl96 x 103/µl95 x 103/µl94 x 103/µl
93 x 103/µl92 x 103/µl91 x 103/µl90 x 103/µl89 x 103/µl88 x 103/µl87 x 103/µl86 x 103/µl
85 x 103/µl84 x 103/µl83 x 103/µl82 x 103/µl81 x 103/µl80 x 103/µl79 x 103/µl78 x 103/µl
77 x 103/µl76 x 103/µl75 x 103/µl     
Moderate thrombocytopenia
74 x 103/µl73 x 103/µl72 x 103/µl71 x 103/µl70 x 103/µl69 x 103/µl68 x 103/µl67 x 103/µl
66 x 103/µl65 x 103/µl64 x 103/µl63 x 103/µl62 x 103/µl61 x 103/µl60 x 103/µl59 x 103/µl
58 x 103/µl57 x 103/µl56 x 103/µl55 x 103/µl54 x 103/µl53 x 103/µl52 x 103/µl51 x 103/µl
50 x 103/µl       
Marked thrombocytopenia
49 x 103/µl48 x 103/µl47 x 103/µl46 x 103/µl45 x 103/µl44 x 103/µl43 x 103/µl42 x 103/µl
41 x 103/µl40 x 103/µl39 x 103/µl38 x 103/µl37 x 103/µl36 x 103/µl35 x 103/µl34 x 103/µl
33 x 103/µl32 x 103/µl31 x 103/µl30 x 103/µl29 x 103/µl28 x 103/µl27 x 103/µl26 x 103/µl
25 x 103/µl       
Severe thrombocytopenia
24 x 103/µl23 x 103/µl22 x 103/µl21 x 103/µl20 x 103/µl19 x 103/µl18 x 103/µl17 x 103/µl
16 x 103/µl15 x 103/µl14 x 103/µl13 x 103/µl12 x 103/µl11 x 103/µl10 x 103/µl9 x 103/µl
8 x 103/µl7 x 103/µl6 x 103/µl5 x 103/µl4 x 103/µl3 x 103/µl2 x 103/µl1 x 103/µl
0 x 103/µl       
Medically reviewed by our Medical staff on 24/03/2021

Bibliography

  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 215.
  • Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0.Published: November 27, 2017. U.S. Department of health and human Services. Available on: https://ctep.cancer.gov
  • Laboratory tests and diagnostic procedures with nursing diagnoses (8th ed), Jane Vincent Corbett, Angela Denise Banks, ISBN: 978-0-13-237332-6, Pag. 317.
  • A Manual of Laboratory and Diagnostic Test. 9th edition. Frances Fischbach. Marshall B. Dunning III. 2014. Pag 148. ISBN-10: 1451190891.

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