When Kelly Williams, a current national player and last year's Most Valuable Player (MVP), immediately flew back to Manila from Negros Occidental during the All-Star festival for the treatment, a lot of fuzz was generated about his rare blood condition. He is suffering from a low platelet count and the Sta. Lucia Realtors (SLR) are resting him to prevent further bleeding.
But what really is this Low Platelet Count disorder?
According to the Merck Manual of Health and Aging, a low platelet count (called thrombocytopenia) refers to an abnormally low number of platelets, the particles in blood that help with clotting. As a result, blood does not clot normally.
Usually, the platelet count is about 150,000 to 350,000 platelets in a microliter of blood. In people with a low platelet count, bleeding is more likely to occur, even after a slight injury. When the platelet count is very low (below 20,000), massive bleeding may occur even when there is no injury. Bleeding may be life threatening.
CAUSES
The platelet count may decrease if the bone marrow does not produce enough platelets. Leukemia, lymphomas, infection with human immunodeficiency virus (HIV, which causes AIDS), and a variety of other bone marrow disorders can have this effect. Or the platelet count may decrease if the spleen enlarges and traps platelets. Thus, fewer platelets are in the bloodstream. Myelofibrosis and some forms of cirrhosis can have this effect.
The body may use or destroy too many platelets. HIV infection, lupus (systemic lupus erythematosus), idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, and hemolytic-uremic syndrome can have this effect. Some drugs, such as heparin and certain antibiotics, also have this effect.
In idiopathic thrombocytopenic purpura, the immune system produces abnormal antibodies that destroy the body's platelets. Why the antibodies develop is unknown. The bone marrow produces more platelets to compensate but cannot keep up with the demand.
Taking heparin may cause a low platelet count. Heparin is a drug that makes blood less likely to clot (anticoagulant). But paradoxically, it sometimes stimulates clot formation. Then the platelet count decreases because so many platelets are used up.
Drinking alcohol may result in a low platelet count by damaging the bone marrow. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and antihistamines may interfere with how platelets function, although the platelet count remains normal.
SYMPTOMS
Bleeding in the skin may be the first sign that the platelet count is low. Often, many tiny red dots appear in the skin on the lower legs. People may bruise easily. Slight injuries sometimes cause small scattered bruises. The gums may bleed, and blood may appear in the stool or urine. Bleeding due to injuries may be hard to stop.
Bleeding worsens as the platelet count decreases. When the count is below 20,000, bleeding in the digestive tract or brain may occur even when there is no injury. This bleeding may be life threatening.
DIAGNOSIS
Doctors suspect a low platelet count when people bruise easily and bleed excessively. Blood tests are done to determine the platelet count and thus confirm the diagnosis. Using an electronic counter to count platelets helps determine how low the platelet count is. The time blood takes to clot (bleeding time) may also be measured. Sometimes a low platelet count is detected when blood tests are done for other reasons. People who have a disorder that can reduce the platelet count should periodically have blood tests.
Doctors try to identify the cause, so that appropriate treatments can be used. Symptoms may suggest a cause. A fever suggests an infection. An enlarged spleen, felt during a physical examination, suggests a disorder that causes the spleen to enlarge.
A sample of bone marrow may be removed and examined under a microscope. This procedure, called a bone marrow biopsy, may be done to determine whether the bone marrow is producing enough platelets.
TREATMENT
If the platelet count is below 20,000, people are usually treated in a hospital or advised to stay in bed to avoid injury. They are usually given a transfusion of platelets. If the platelet count is 20,000 to 30,000 and excessive bleeding occurs, platelets are usually transfused.
Treating a disorder that has reduced the platelet count often restores the count to normal. If taking heparin is the cause, it is usually discontinued.
For some disorders such as idiopathic thrombocytopenic purpura, a corticosteroid such as prednisone may be used to temporarily prevent antibodies from destroying platelets. Then the platelet count increases. After the corticosteroid is discontinued, the count may decrease again. In such cases, people may need to continue a corticosteroid for the rest of their life, or one of several other treatments may be tried.
If the spleen is trapping too many platelets, the spleen may be surgically removed. This procedure (splenectomy) increases the platelet count.
But what really is this Low Platelet Count disorder?
According to the Merck Manual of Health and Aging, a low platelet count (called thrombocytopenia) refers to an abnormally low number of platelets, the particles in blood that help with clotting. As a result, blood does not clot normally.
Usually, the platelet count is about 150,000 to 350,000 platelets in a microliter of blood. In people with a low platelet count, bleeding is more likely to occur, even after a slight injury. When the platelet count is very low (below 20,000), massive bleeding may occur even when there is no injury. Bleeding may be life threatening.
CAUSES
The platelet count may decrease if the bone marrow does not produce enough platelets. Leukemia, lymphomas, infection with human immunodeficiency virus (HIV, which causes AIDS), and a variety of other bone marrow disorders can have this effect. Or the platelet count may decrease if the spleen enlarges and traps platelets. Thus, fewer platelets are in the bloodstream. Myelofibrosis and some forms of cirrhosis can have this effect.
The body may use or destroy too many platelets. HIV infection, lupus (systemic lupus erythematosus), idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, and hemolytic-uremic syndrome can have this effect. Some drugs, such as heparin and certain antibiotics, also have this effect.
In idiopathic thrombocytopenic purpura, the immune system produces abnormal antibodies that destroy the body's platelets. Why the antibodies develop is unknown. The bone marrow produces more platelets to compensate but cannot keep up with the demand.
Taking heparin may cause a low platelet count. Heparin is a drug that makes blood less likely to clot (anticoagulant). But paradoxically, it sometimes stimulates clot formation. Then the platelet count decreases because so many platelets are used up.
Drinking alcohol may result in a low platelet count by damaging the bone marrow. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and antihistamines may interfere with how platelets function, although the platelet count remains normal.
SYMPTOMS
Bleeding in the skin may be the first sign that the platelet count is low. Often, many tiny red dots appear in the skin on the lower legs. People may bruise easily. Slight injuries sometimes cause small scattered bruises. The gums may bleed, and blood may appear in the stool or urine. Bleeding due to injuries may be hard to stop.
Bleeding worsens as the platelet count decreases. When the count is below 20,000, bleeding in the digestive tract or brain may occur even when there is no injury. This bleeding may be life threatening.
DIAGNOSIS
Doctors suspect a low platelet count when people bruise easily and bleed excessively. Blood tests are done to determine the platelet count and thus confirm the diagnosis. Using an electronic counter to count platelets helps determine how low the platelet count is. The time blood takes to clot (bleeding time) may also be measured. Sometimes a low platelet count is detected when blood tests are done for other reasons. People who have a disorder that can reduce the platelet count should periodically have blood tests.
Doctors try to identify the cause, so that appropriate treatments can be used. Symptoms may suggest a cause. A fever suggests an infection. An enlarged spleen, felt during a physical examination, suggests a disorder that causes the spleen to enlarge.
A sample of bone marrow may be removed and examined under a microscope. This procedure, called a bone marrow biopsy, may be done to determine whether the bone marrow is producing enough platelets.
TREATMENT
If the platelet count is below 20,000, people are usually treated in a hospital or advised to stay in bed to avoid injury. They are usually given a transfusion of platelets. If the platelet count is 20,000 to 30,000 and excessive bleeding occurs, platelets are usually transfused.
Treating a disorder that has reduced the platelet count often restores the count to normal. If taking heparin is the cause, it is usually discontinued.
For some disorders such as idiopathic thrombocytopenic purpura, a corticosteroid such as prednisone may be used to temporarily prevent antibodies from destroying platelets. Then the platelet count increases. After the corticosteroid is discontinued, the count may decrease again. In such cases, people may need to continue a corticosteroid for the rest of their life, or one of several other treatments may be tried.
If the spleen is trapping too many platelets, the spleen may be surgically removed. This procedure (splenectomy) increases the platelet count.
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