Thrombocytopenia is a hematologic disorder in which blood platelet count decreases below the normal range, i.e. 150000-450000/ml. Platelets are the colorless components of blood which stick together and help in clotting. In this condition either the platelets, production is low or destruction is more. It is usually the result of some separate disease like an immune system problem or leukemia. Either adults or children can be affected. It may range from mild to severe form in which either there are very less sign and symptoms or internal bleeding, respectively. Thrombocytopenia can be life-threatening.
What are the Sign and Symptoms of Thrombocytopenia?
- Purpura, i.e. excessive or easy bleeding
- Petechiae, usually on lower legs, i.e. bleeding in the skin which appears as a pinpoint-sized spots
- Prolonged bleeding time and decreased clotting time
- Bleeding from nose and gums
- Blood in stool or urine
- Enlarged spleen
What are the Causes of Thrombocytopenia?
1. Platelet trapping
The spleen is a small sized vital organ which stores RBCs and platelets. Approximately 30% of platelets are stored in it. Spleen fights with infections and filters harmful and unwanted substances from the blood. There may occur an increase in the size of the spleen due to various causes like bacterial, viral infections, rheumatoid arthritis, cancers (Leukemia and Hodgkin lymphoma), sarcoidosis, liver diseases (Sclerosing cholangitis and cirrhosis). Increase in size may cause harboring of too many platelets in it. This results in a decreased number of platelets in circulation.
2. Decreased production of platelets
Production of platelets occurs in bone marrow by megakaryocytes. Megakaryocytes are large bone marrow cells. So any condition or disorder resulting in suppression of megakaryocytes or bone marrow decreases the production of platelets. Some of the causes can be:
- Certain anemia
- Viral infections like HIV or hepatitis C
- Chemotherapy drugs
- Excessive alcohol consumption
If we talk about alcoholism, it has the deteriorating effects on blood cells including WBCs, RBCs, and platelets. It also hampers nutrition due to which the production of blood cells is not proper. Alcohol inhibits the action of thromboxane enzyme which is responsible for the aggregation of the platelets.
Secondly, chemotherapy results in suppression of bone marrow which is one of the causes of thrombocytopenia.
3. Increased platelet breakdown
This may occur due to various reasons like:
- Immune thrombocytopenia – In this condition there is the production of antiplatelet antibodies which destroys the platelets as well as affecting the megakaryocytes, hampering the production of the Platelets.
- Hemolytic uremic syndrome – This is a disorder which has a sudden onset leading to platelet destruction. In this loose strand of fibrin and platelets are deposited in small blood vessels that damage the platelets.
4. Thrombocytopenia in pregnancy
It is usually rare but some women do experience it during pregnancy. In pregnancy, an enzyme thromboxane A2 is increased which leads to increased platelet consumption and decreased production. Other conditions associated with pregnancy like pre-eclampsia, hemolysis, gestational thrombocytopenia and elevated liver enzymes can lead to thrombocytopenia.
It is one of the most common causes of thrombocytopenia as it brings hemodynamic disturbances along with it. Like hypovolemia, increased vascular permeability, hypotension, and shock. According to Who thrombocytopenia is a potential clinical indicator of the severity of dengue. Some of the basic reasons for thrombocytopenia in dengue are:
- Bone marrow suppression – There is the presence of low amount of cells in bone marrow and a decrease in the maturation of megakaryocyte in dengue. This is brought about by damage of blood cells by dengue virus. Thrombopoietin is elevated when the count of platelets decreases and hence it is used as a marker of dengue.
- Increased destruction of platelets – In dengue,e antibodies are produced against platelets which result in its destruction. During dengue infection a complement system in the body ( it is a part of the immune system which increases the ability of phagocytotic cells and antibodies to clear the virus and damaged cells from the body). Hence platelets are also consumed in this process and spleen enlarges which starts storing platelets abnormally resulting in low circulating platelets.
6. Certain medications
Certain drugs used for treating some disease can confuse the immune system and result in abnormal destruction of platelets. For example quinine, heparin, anticonvulsants, and sulfa-containing antibiotics.
7. Bacteria in blood
Bacteremia, i.e. severe blood infection can cause the destruction of platelets.
How can Thrombocytopenia be Diagnosed?
- CBC, i.e. complete blood count test through which we can assess the total number of blood cells present, each separately.
- Physical examination to looks for any signs of bleeding under the skin. Abdominal palpation to see if the spleen is enlarged.
How can Thrombocytopenia be Treated?
- Treating underlying cause
- Platelet or blood transfusion
- Surgery (To remove spleen)
- Plasma exchange
What is Ayurvedic Treatment of Thrombocytopenia?
Ayurvedic treatment of thrombocytopenia depends upon the severity of the symptoms. Ayurvedic treatment involves changes in diet and lifestyle along with the intake of herbal remedies or herbs. The aim of treatment is the proper functioning of the body’s immune system and maintaining the repair mechanism of the body. These herbs also help in relieving inflammation and pain associated with it.
Some of the herbs specifically used to bring up the platelet count naturally are listed below:
1.Giloy- As giloy is enriched with anti-inflammatory, antibacterial and antiallergic properties, it is known as amrit in Ayurveda. Intake of giloy juice extracted from its stem works wonderfully in boosting up the proper functioning of the immune system.
2.Ashwagandha- This herb is known as an immune modulator and boosts the production of platelets along with red blood cells and white blood cells. Ashwagandha increases the body’s stamina and combats stress. Berries of ashwagandha herb work as a blood purifier and help to improve blood circulation in the body.
3.Gotu Kola- Capsules made from gotukola herb effectively increases platelet count and helps the body to fight against anxiety, fatigue, depression, and infections. It helps to improve blood circulation.
4.Punarnava mandur- This herb is an efficient body detoxifier and improves blood circulation. Herbal remedies made from punarnava helps to treat edema and other related ailments.
In thrombocytopenia recommended Ayurvedic diet includes intake of vitamin B12 which is found in lentils, asparagus, beans, beets, yogurt, spinach, and beets. Take cruciferous vegetables like cauliflower, broccoli, cabbage, etc and fresh fruits.