Materiały źródłowe

• #1 Thrombocytopenia | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0315/p612.html

  Thrombocytopenia is defined as a platelet count of less than 150 103 per L. It is often discovered incidentally when obtaining a complete blood count during an office visit. Patients with platelet counts greater than 50 103 per L rarely have symptoms. A platelet count from 30 to 50 103 per L rarely manifests as purpura. A count from 10 to 30 103 per L may cause bleeding with minimal trauma. A platelet count less than 5 103 per L may cause spontaneous bleeding and constitutes a hematologic emergency. […] Patients with a platelet count greater than 50 103 per L (50 109 per L) often are asymptomatic. Patients with a count from 30 to 50 103 per L (30 to 50 109 per L) rarely present with purpura, although they may have excessive bleeding with trauma. However, counts from 10 to 30 103 per L (10 to 30 109 per L) may cause bleeding with minimal trauma, and counts less than 10 103 per L increase the risk of spontaneous bleeding, petechiae, and bruising. Spontaneous bleeding (i.e., mucosal, intracranial, gastrointestinal, and genitourinary bleeding) is more likely in patients with platelet counts less than 5 103 per L (5 109 per L), and is considered a hematologic emergency.

• #2 Hemophilia vs. Thrombocytopenia | Sierra Hematology & Oncology

  https://www.sierrahemonc.com/blog/are-hemophilia-and-thrombocytopenia-the-same-know-the-differences/

  Thrombocytopenia is a condition marked by low platelet levels, slowing down clot formation. This reduction in platelets affects the blood’s ability to clot swiftly, increasing the risk of bleeding. […] Thrombocytopenia arises when an individual’s platelet count drops below 150,000 platelets per microliter of blood. […] Thrombocytopenia involves a shortage of platelets, crucial for clot formation, while hemophilia is characterized by low levels or absence of clotting factor proteins necessary for the coagulation process. […] On a related note, thrombocytopenia is another condition influencing bleeding tendencies. It revolves around platelet levels in the blood. When these levels are low, the process of blood clotting slows down, potentially resulting in prolonged bleeding after an injury. Severe cases of thrombocytopenia may even lead to significant and potentially dangerous bleeding episodes.

• #3 Immune Thrombocytopenia (ITP): Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/5726-immune-thrombocytopenia

  Immune thrombocytopenia (ITP) is a rare blood disorder that affects how your blood clots. When your blood cant clot, you may bruise easily, bleed more than normal when youre hurt or start bleeding for no reason. Sometimes, ITP goes away without treatment. Other times, its a chronic condition, meaning treatment eases symptoms but doesnt cure it. […] Symptoms include petechia and purpura. Immune thrombocytopenia (ITP) may not cause symptoms. When it does, symptoms may include petechia (left) or purpura (right). […] You may not have any symptoms, but they can happen slowly or quickly if you do. Symptoms may include: […] Petechiae: This symptom appears as tiny red or purple dots on your lower legs that resemble a rash. […] Purpura: This is when petechiae join together, forming red, purple or brown spots on your skin. The spots are larger than petechiae but smaller than a bruise. This happens when small blood vessels under your skin leak blood.

• #4 Thrombocytopenia: Types Stages Signs Symptoms & Treatment

  https://www.truemeds.in/diseases/hematologic/thrombocytopenia-147

  Thrombocytopenia is a condition characterised by a low platelet count in the blood, which can lead to an increased risk of bleeding. It can be caused by various factors, including autoimmune disorders, bone marrow diseases, and certain medications. The severity of thrombocytopenia is classified into mild, moderate, and severe stages based on the platelet count. […] Symptoms of thrombocytopenia can vary but typically include a range of warning signs that indicate low platelet levels. These include: Easy bleeding: People with thrombocytopenia may experience easy bleeding due to low platelet counts. This can manifest in various ways, including nosebleeds, bleeding gums, and heavier or longer menstrual periods. Additionally, they may notice blood in their urine or stool. […] The severity of thrombocytopenia is categorised into three stages based on the platelet count. These include: Mild thrombocytopenia: In mild thrombocytopenia, the platelet count ranges from 101,000 to 140,000 per μl. At this stage, the risk of bleeding is minimal, and bleeding may only occur after minor injuries or trauma. Moderate thrombocytopenia: Moderate thrombocytopenia is characterised by a platelet count ranging from 51,000 to 100,000 per μl. With this level of thrombocytopenia, the risk of bleeding increases moderately, and bleeding may occur more easily following injuries. Severe thrombocytopenia: In severe thrombocytopenia, the platelet count falls below 50,000 per μl. This stage poses a significant risk of bleeding, which can lead to life-threatening complications. Minor bleeding can occur spontaneously without any apparent injury, and excessive bleeding is likely during surgical procedures or in cases of trauma.

• #4 Thrombocytopenia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/thrombocytopenia/

  Thrombocytopenia is often asymptomatic and found incidentally on routine bloodwork. Patients may notice petechiae or mucosal bleeding (e.g., bleeding gums, epistaxis) at lower platelet counts. Other patients with thrombocytopenia are clinically ill and have multisystem findings (e.g., acute infection, liver disease, TTP/HUS, DIC). Diagnosis should be confirmed with repeat testing (to rule out pseudothrombocytopenia) and underlying causes should be investigated and treated. Patients with active bleeding or neurological symptoms require emergency platelet transfusion, and in cases of immune-mediated etiologies, IVIG. […] Clinical features according to platelet count: Mild (70,000-149,999/mm3): Typically: no abnormal bleeding, i.e., asymptomatic thrombocytopenia. Moderate (20,000-70,000/mm3): Prolonged bleeding following surgery or trauma, Easy bruising, Occasionally: petechiae and purpura. Severe (3): Spontaneous bruising (ecchymoses), petechiae, and purpura, Bleeding from the mucosa (e.g., bleeding gums) or after minimal trauma, Increased risk of spontaneous, life-threatening bleeding. […] Patients with thrombocytopenia may be asymptomatic or acutely unwell if the thrombocytopenia is a feature of a wider syndrome such as DIC or TTP. Management depends on symptoms, initial platelet count, and the underlying condition.

• #5 Platelet Disorders – Thrombocytopenia | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/thrombocytopenia

  Thrombocytopenia is a condition that occurs when the platelet count in your blood is too low. […] When you have a low platelet count, you may have trouble stopping bleeding. Bleeding can happen inside your body, underneath your skin, or from the surface of your skin. You may not have serious bleeding until your platelet count is very low. […] Thrombocytopenia can be life-threatening, especially if you have serious bleeding or bleeding in your brain. Early treatment can help you avoid serious complications. […] Symptoms can appear suddenly or over time. Mild thrombocytopenia often has no symptoms. Many times, it is found during a routine blood test. […] Signs of bleeding may include: Bleeding that lasts a long time, even from small injuries; Petechiae, which are small, flat red spots under the skin caused by blood leaking from blood vessels; Purpura, which is bleeding in your skin that can cause red, purple, or brownish-yellow spots; Nosebleeds or bleeding from your gums; Blood in your urine or stool, which can appear as red blood or as a dark, tarry color; Heavy menstrual bleeding. […] Without proper treatment, thrombocytopenia can cause serious bleeding. This can happen both inside your body and out of your skin. It can be life-threatening.

• #6 Overview of Thrombocytopenia – Blood Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/blood-disorders/platelet-disorders/overview-of-thrombocytopenia

  Thrombocytopenia is a low number of platelets in the blood, which increases the risk of bleeding. […] Bleeding in the skin and bruising occur. […] Bleeding in the skin may be the first sign of a low platelet count. Many tiny red dots (petechiae) often appear in the skin on the lower legs, and minor injuries may cause bruises (ecchymoses or purpura). The gums may bleed, and blood may appear in the stool or urine. Menstrual periods may be unusually heavy. Bleeding may be hard to stop. […] Bleeding worsens as the number of platelets decreases. People who have very few platelets may lose large amounts of blood into their digestive tract or may develop life-threatening bleeding in their brain even though they have not been injured. […] The rate at which symptoms develop can vary depending on the cause and severity of thrombocytopenia.

• #7 Immune thrombocytopenia (ITP) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/symptoms-causes/syc-20352325

  Immune thrombocytopenia (ITP) is an illness that can lead to bruising and bleeding. Low levels of the cells that help blood clot, also known as platelets, most often cause the bleeding. […] Immune thrombocytopenia might not have symptoms. When symptoms occur, they might include: Easy bruising. Bleeding into the skin that looks like tiny reddish-purple spots, also known as petechiae. The spots mostly show up on the lower legs. They look like a rash. Bleeding into the skin that’s larger than petechiae, also known as purpura. Bleeding from the gums or nose. Blood in urine or stools. Really heavy menstrual flow. […] People with ITP who aren’t bleeding and whose platelet count isn’t too low might not need treatment. For worse symptoms, treatment might include medicines to raise platelet count or surgery to remove the spleen.

• #8 Chronic Immune Thrombocytopenia (ITP)

  https://www.webmd.com/a-to-z-guides/chronic-immune-thrombocytopenia

  A major (significant) drop in platelets can make you bruise or bleed more easily. Common bleeding symptoms from ITP include: […] Many people have no symptoms in the early stages when ITP is mild. Once your platelet count drops very low, you may bruise or bleed more easily than usual. […] A low platelet count also causes symptoms like these: […] Acute ITP symptoms often disappear after a few weeks. Chronic ITP symptoms last for a year or longer. The symptoms can continue for many years, or even for a lifetime. […] An ITP diagnosis could make you wonder about your future. Will this disease be with you for a lifetime? Could it shorten your life? Everyone’s condition is unique, but overall, ITP has a good outlook thanks to improved treatments. […] Acute ITP usually gets better within a few weeks or months. Chronic ITP can last for many years. Symptoms may come and go, but the condition is usually not life-threatening. You’ll need medications or other treatments long-term to keep your platelet count up and prevent serious bleeding. […] ITP can cause severe bleeding without treatment. The most serious complication is bleeding in the brain, which could be life-threatening.

• #9 Thrombocytopenia (Low Platelet Count): Causes, Symptoms, and Treatment Options

  https://www.webmd.com/a-to-z-guides/thrombocytopenia-symptoms-causes-treatments

  Thrombocytopenia Symptoms […] Usually, you won’t feel anything when you have thrombocytopenia. The condition often has no symptoms. But when you do have symptoms, they can include: […] Bleeding. This happens most often from your gums or nose. Thrombocytopenia also can cause heavier or longer periods or breakthrough bleeding if you have a menstrual cycle. You may also see blood in your pee or poop. […] Blotches and bruises. You might have large areas of bleeding under the skin that don’t turn white when you press on them. You also might see what looks like the bruises you get from a bump or after being hit. They could be blue or purple and change to yellow or green over time. These are caused from the inside by the sudden leaking from tiny blood vessels. The medical name for these is purpura. […] Red, flat spots on your skin. You’ll see these spots the size of a pinhead mostly on your legs and feet, and they may appear in clumps. Your doctor may call them petechiae. Petechiae don’t turn white when you put pressure on them. […] Fatigue. Low platelets by itself won’t make you feel run down and tired. But other conditions that cause low platelets can leave you feeling fatigued. […] Enlarged spleen. You’ll have this if your spleen is trapping platelets, which may be one reason for your low counts.

• #10 Thrombocytopenia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/thrombocytopenia

  Symptoms include bleeding gums, nosebleeds, bruising easily, heavy menstrual blood flow. […] Some people with mild and moderate thrombocytopenia do not have any symptoms. Some people with severe thrombocytopenia may experience: […] Bleeding gums or other areas in the mouth, nosebleeds, bruising easily, heavy menstrual blood flow, blood in the urine, stool, mucus, and/or vomit, petechiae, a rash with flat, pin-sized red spots caused by bleeding beneath the skin, purpura, a solid purple-red rash caused by bleeding under the skin, bleeding in the brain due to injury. […] There are mild and severe forms of thrombocytopenia. The mild forms are not urgent and rarely cause abnormal bleeding. In contrast, severe forms are life-threatening, causing gastrointestinal bleeding, heavy menstruation or brain hemorrhages (bleeding within the brain). […] When platelet levels drop below 50,000 platelets per microliter, there is an increased risk of bleeding. When platelet counts are below 10,000 platelets per microliter, there is a high risk of life-threatening bleeding.

• #11 Thrombocytopenia (low platelets) | Lymphoma Action

  https://lymphoma-action.org.uk/about-lymphoma-side-effects-treatment/thrombocytopenia-low-platelets

  Thrombocytopenia can make you more likely to bruise or bleed. […] Most people with a low platelet count don’t have any symptoms. This is because your body has a built-in reserve with many more platelets than you need for day-to-day life. […] If your platelet count falls to very low levels, you might notice some symptoms and signs. In general, the lower your platelet count, the stronger the symptoms. Symptoms can include: bruising more easily than usual, bleeding for longer than usual after a cut, bleeding after minor injuries that wouldn’t normally bleed. […] If you have a low platelet count that causes bleeding, you might also develop anaemia. […] Contact your medical team if you develop any of the following symptoms: nosebleeds, bleeding gums after brushing your teeth, heavier or longer periods than is usual for you, bleeding for longer than you’d expect after a cut or scratch, bruising more easily than usual, red or purple patches or spots called purpura or petechiae on your skin (often on your legs), your lips or in your mouth, blood in your sick (vomit), blood in your wee, blood in your poo (this might be obvious, bright red blood or it can make your poo black and sticky), painful joints, persistent headache, blurred vision or a change in your level of consciousness. […] Thrombocytopenia often gets better on its own quite quickly, and many people with a low platelet count don’t need any treatment at all. However, if your platelet count is very low, or you are at particular risk of bleeding, you might need treatment.

• #12 Low Platelet Count (Thrombocytopenia)

  https://www.healthline.com/health/thrombocytopenia

  Having a low platelet count can affect your bloods ability to clot. This can result in uncontrolled bleeding, which can sometimes require immediate medical attention. […] A low platelet count is called thrombocytopenia. This condition can range from mild to severe, depending on its underlying cause. Some people with thrombocytopenia may not experience any symptoms; for more severe cases, uncontrollable bleeding can result in death. […] Whether or not you experience symptoms of thrombocytopenia may depend on how low your platelet count is. […] If you have a low platelet count, you may experience: red, purple, or brown bruises, called purpura; a rash with small red or purple dots, called petechiae; nosebleeds; bleeding gums; bleeding from wounds that lasts for a prolonged period or doesn’t stop on its own; heavy menstrual bleeding.

• #13 Signs, Symptoms, and Complications of Thrombocytopenia | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-thrombocytopenia/signs-symptoms-and-complications

  Heavy bleeding into the intestines or the brain (internal bleeding) is serious and can be fatal. Signs and symptoms include: Blood in the urine or stool or bleeding from the rectum. Blood in the stool can appear as red blood or as a dark, tarry color. (Taking iron supplements also can cause dark, tarry stools.) Headaches and other neurological symptoms. These problems are very rare, but you should discuss them with your doctor.

• #14 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/202158-overview

  ITP manifests as a bleeding tendency, easy bruising (purpura), or extravasation of blood from capillaries into skin and mucous membranes (petechiae). […] Although most cases of acute ITP, particularly in children, are mild and self-limited, intracranial hemorrhage may occur when the platelet count drops below 10 109/L ( 10 103/L); this occurs in 0.5-1% of children, and half of these cases are fatal. […] Findings suggestive of intracranial hemorrhage include the following: Headache, blurred vision, somnolence, or loss of consciousness. […] The primary cause of long-term morbidity and mortality in patients with immune thrombocytopenia (ITP) is hemorrhage. Spontaneous or accidental trauma-induced intracranial hemorrhage is the most frequent cause of death in association with ITP. Most cases of intracranial hemorrhage occur in patients whose platelet counts are less than 10 109/L ( 10 103/L).

• #15 Thrombocytopenia – symptoms, causes, diagnosis and treatment | healthdirect

  https://www.healthdirect.gov.au/thrombocytopenia

  Thrombocytopenia is when you have low levels of platelets in your blood. […] Symptoms of thrombocytopenia are: easy bruising, abnormal bleeding (nosebleeds, bleeding gums, heavy heavy periods), blood in your poo or urine (wee), pinpoint bleeding in your skin that looks like a purplish-red rash (known as petechiae), cuts that keep bleeding. […] Dangerous bleeding can sometimes occur if you have thrombocytopenia.

• #16 Thrombocytopenia: Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/14430-thrombocytopenia

  Thrombocytopenia occurs when your bone marrow doesnt make enough platelets. Platelets are blood cells that form blood clots to help stop bleeding. People with this condition may bleed a lot and the bleeding may be hard to stop. […] If you have thrombocytopenia, you may bleed a lot, and the bleeding may be hard to stop. […] Some people with mild cases of thrombocytopenia dont have symptoms. When they do, one of the first symptoms is a cut or nosebleed that wont stop bleeding. Other symptoms include: […] Thrombocytopenia symptoms can develop very quickly or over time. It may also cause bleeding in many parts of your body. Seek medical care if: […] Thrombocytopenia low platelet levels may increase your risk of issues like excessive bleeding and bruising. Severe thrombocytopenia increases your risk of internal bleeding or heart attack.

• #17 Low platelet count (thrombocytopenia) | Canadian Cancer Society

  https://cancer.ca/en/treatments/side-effects/low-platelet-count

  Thrombocytopenia is a condition caused by a low number of platelets in the blood. People with a low number of platelets may bleed or bruise easily, even after a minor injury. A low platelet count increases the risk of bleeding, especially from the mouth, nose and gastrointestinal tract. […] Symptoms of thrombocytopenia usually dont develop until the number of platelets is very low. Symptoms of low platelet count may begin soon after chemotherapy starts, but they are usually at their worst 10-14 days after you first receive chemotherapy. […] Symptoms of a low platelet count include: bruising easily, tiny red spots, or petechiae, under the skin, unusual bleeding from the gums or nose, a lot of or long-lasting bleeding from a small cut or injection site, blood in the urine, which may look pink, red or brown, blood in the stool or black-coloured stool, vomiting blood or something that looks like coffee grounds, vaginal bleeding that is different from and lasts longer than the normal menstrual period, constant headache, blurred vision or change in level of consciousness. […] Thrombocytopenia caused by chemotherapy is usually temporary, but it can cause a serious loss of blood or bleeding that can damage internal organs.

• #18 Thrombocytopenia | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0315/p612.html

  The risk of bleeding correlates to the severity of thrombocytopenia. Patients may present without symptoms, with minimal bleeding, or with serious hemorrhage (e.g., mucosal, intracranial, gastrointestinal, genitourinary). Older patients, patients on antiplatelet therapy, and patients with comorbid conditions may have more severe bleeding manifestations. […] Immune thrombocytopenic purpura is an acquired immune-mediated disorder characterized by isolated thrombocytopenia and the absence of other conditions or agents known to induce thrombocytopenia. The incidence is 100 cases per 1 million persons annually, and approximately 50 percent of cases occur in children. Immune thrombocytopenic purpura in children often resolves spontaneously but tends to be more insidious and chronic in adults. […] Heparin-induced thrombocytopenia should be suspected in patients recently treated with heparin. Platelet counts decline within five to 10 days in patients with no previous exposure to heparin and may decline precipitously (within hours) in patients with recent heparin exposure. This life-threatening disorder is characterized by the presence of platelet-activating antibodies recognizing multimolecular complexes bound to unfractionated heparin or low-molecular-weight heparin.

• #19 Thrombocytopenia Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/thrombocytopenia.html

  People with severe thrombocytopenia may have abnormal bleeding almost anywhere in the body. […] Symptoms can include: […] Reddish or purplish spots in the skin (called petechiae), often concentrated in the lower legs […] Excessive bruising, even from minor trauma […] Blood in the urine or stool […] Abnormal or excessive bleeding from the mouth or nose […] Abnormal vaginal bleeding, especially unusually heavy menstrual flow […] Bleeding inside the gastrointestinal tract, including bleeding from the rectum […] Excessive bleeding after surgery or dental work […] Headache and other neurological symptoms caused by bleeding inside the brain. This is extremely rare and only occurs when platelet counts become extremely low. […] For example, some patients with chronic ITP experience years of easy bruising and abnormally heavy vaginal bleeding. They may have repeated episodes of more severe bleeding.

• #20 Immune Thrombocytopenia (ITP) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/thrombocytopenia-and-platelet-dysfunction/immune-thrombocytopenia-itp

  In children or adults with immune thrombocytopenia and life-threatening bleeding, rapid phagocytic blockade is attempted by giving IVIG 1 g/kg once a day for 1 to 2 days or, in Rh-positive patients, a single dose of IV anti-D immune globulin 75 mcg/kg. […] Patients with ITP and life-threatening bleeding are also given platelet transfusions. […] Children typically recover spontaneously, even from severe thrombocytopenia, in several weeks to months. […] In adults, spontaneous remission occurs in under 10%. With completion of initial treatment, about one third of patients undergo remission. Up to 75% of patients improve within 5 years.

• #21 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/202158-overview

  More than 80% of children with untreated immune thrombocytopenia (ITP) have a spontaneous recovery with completely normal platelet counts in 2-8 weeks. Fatal bleeding occurs in 0.9% upon initial presentation. […] Approximately 60-90% of adults with ITP respond with an increased platelet count after treatment with prednisone or prednisone and IV RhIG or IVIG. Of those adults who do not maintain an increased platelet count and who require splenectomy, approximately two thirds have a sustained response and 10-15% have a partial response.

• #22 Immune thrombocytopenic purpura (ITP) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/idiopathic-thrombocytopenic-purpura-itp

  Immune thrombocytopenic purpura (ITP) is a rare autoimmune disorder that causes you to have low platelet levels. […] A person with ITP may have a platelet count of 20 000 (20×109/L) or lower. […] However, if the platelet count drops very low, they may experience an increase in bruising or bleeding. These symptoms may include: skin that bruises very easily, a skin rash of small red dots (petechiae), which does not blanch (go pale) with pressure, bleeding from any area of the body, bleeding from the gums, frequent nosebleeds that take a long time to stop, internal bleeding, long or heavy menstrual periods. […] Fatigue is also a common symptom in ITP. The cause of this is poorly understood as platelets are not involved in maintaining energy levels. […] In many cases of acute ITP, the platelet count will rise again within a few weeks and return to normal within a few months. […] Occasionally, a person who appears to have been cured of ITP will experience a relapse, perhaps months or even years after the initial episode. If this happens the person will need repeat treatment. The relapse may be triggered by a viral infection.

• #23 Cyclic Thrombocytopenia | The ITP Support Association

  https://itpsupport.org.uk/cyclic-thrombocytopenia/

  Cyclic thrombocytopenia (CTP) is a very rare blood disorder characterized by periodic fluctuations in platelet counts. Each of the fluctuations is usually over a period of 3-5 weeks. The levels that the platelet counts reach have been reported as from 10 109 /L at the lowest and climbing to 330 109 /L at the peak. Therefore, patients may oscillate between periods of severe thrombocytopenia, with all its implications, or rebound recovery to levels where there is an increased risk of thrombosis. […] Making the correct diagnosis can be difficult and any patient diagnosed with ITP, who shows unexpected fluctuations in their count should be considered as having CTP and a platelet count diary should be maintained, if possible off all treatment, to follow the trend in the counts. Treatment can be difficult and steroids are often given initially but there is anecdotal evidence that thrombopoietin receptor agonists, such as romiplostim and eltrombopag, may be helpful in reducing the fall in the counts but they may have the unwanted effect of markedly increasing the peaks. They should be used with caution and only under close medical supervision and it goes without saying that treatment should only be considered if there is a bleeding risk. Unfortunately, many patients fail to respond to any therapy. The disease is chronic and may go on for years although occasional examples of spontaneous remissions have been recorded.

• #24 Thrombocytopenia | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0315/p612.html

  Patients presenting with thrombocytopenia and microangiopathic hemolytic anemia should be admitted to the hospital with a presumptive diagnosis of thrombotic thrombocytopenic purpura. Renal manifestations, neurologic changes, and fever also may be present. Severity is reflected by the extent of microvascular aggregation of platelets resulting in ischemia and necrosis of tissue cells. The incidence of thrombotic thrombocytopenic purpura is four to 11 patients per 1 million annually in the United States. […] Pregnant patients beyond 20 weeks’ gestation with thrombocytopenia or signs and symptoms such as headache, visual disturbances, right upper quadrant abdominal pain, or elevated blood pressure should be evaluated for preeclampsia and HELLP syndrome. Laboratory abnormalities may include anemia, elevated liver enzymes, elevated lactate dehydrogenase, and proteinuria.

• #25 25 Symptoms of Vaccine-Induced Immune Thrombotic Thrombocytopenia

  https://www.emedicinehealth.com/what_are_symptoms_of_thrombotic_thrombocytopenia/article_em.htm

  Symptoms of vaccine-induced immune thrombotic thrombocytopenia (VITT) vary depending on where the shot is received, which may include persistent headache, vomiting, visual impairment, focal neurologic deficits or seizures, brain damage or disease (encephalopathy), severe abdominal pain, back pain, leg pain (deep vein thrombosis, or DVT), pulmonary embolism, double vision, vision loss, and others. […] Vaccine-induced immune thrombotic thrombocytopenia usually starts within 5 to 10 days post-vaccination, and cases are typically identified between 5 to 30 days post-vaccination. […] Symptoms of vaccine-induced immune thrombotic thrombocytopenia depend on the part of the body in which the blood clot develops and may include: […] New, persistent headache […] Vomiting […] Visual impairment

• #26 Low Platelet Count (Thrombocytopenia)

  https://www.healthline.com/health/thrombocytopenia

  In more severe cases, you may bleed internally. Symptoms include: blood in your stool; blood in your urine; bloody or very dark vomit. […] In rare cases, thrombocytopenia may lead to bleeding in your brain. […] If left untreated, a low platelet count can be very serious because it can cause internal bleeding of the brain or the intestines. […] In the worst cases, this may even cause death.

• #27 Thrombocytopenia (Low Platelet Count): Causes and Symptoms

  https://www.medicinenet.com/thrombocytopenia_low_platelet_count/article.htm

  The prognosis for someone with thrombocytopenia depends on the cause and the severity of the disease. Generally, when thrombocytopenia is diagnosed early, the outcomes are very good. However, delayed diagnosis can result in problems ranging from a heart attack, and organ damage (for example, spleen, bowel, kidney) to pulmonary embolism, each of which has a more guarded prognosis. […] The complications of thrombocytopenia may be excessive bleeding after a cut or an injury resulting in hemorrhage and major blood loss. However, spontaneous bleeding (without any injury or laceration) due to thrombocytopenia is uncommon, unless the platelet count is less than 10,000.

• #28 Thrombocytopenia Treatment | St. Jude Care & Treatment

  https://www.stjude.org/care-treatment/treatment/blood-disorders/thrombocytopenia.html

  Thrombocytopenia symptoms usually include: Bruising […] Heavy or continued bleeding from cuts or other wounds […] Bleeding from the nose or gums […] Heavy bleeding after dental work […] Very heavy menstrual bleeding […] Pinpoint-sized red spots on the skin, often at the site of local trauma or injury. […] The prognosis for thrombocytopenia varies widely depending on the severity of the condition and the underlying cause. Thrombocytopenia is not usually life-threatening on its own, but its underlying condition may be. Survival rates depend on the cause of thrombocytopenia.

• #29 Thrombocytopenia Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/thrombocytopenia.html

  Most children with acute ITP recover within four to six weeks. […] Some people have such mild disease that they almost never have noticeable bleeding problems. […] Many people with drug-induced thrombocytopenia recover within 7 to 10 days after they stop taking the medication. […] Call your doctor if you develop any of the symptoms of thrombocytopenia. Be sure to call if you notice abnormal bruises or if you experience significant bleeding from your nose, mouth, vagina, rectum or urinary tract. […] The overall outlook is generally good. This is especially true if the cause can be identified and removed. Long-term management of the condition is often successful.

• #30 Immune Thrombocytopenia (ITP) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/immune-thrombocytopenia-itp

  Common symptoms of ITP include: […] In most children, ITP goes away on its own within six to 12 months of diagnosis. […] More than 80 percent of children with ITP recover on their own in six to twelve months regardless of whether they receive medication. After ITP resolves, it can occasionally occur again up to several years after the first episode, sometimes triggered by a viral infection.

• #31 Immune thrombocytopenia (ITP) | disease | symptoms | Sobi

  https://www.sobi.com/en/sobi-itp-immune-thrombocytopenia

  Only nine or ten people in every 100,000 have ITP, a rare autoimmune disease affecting platelet production and characterised by fatigue, bruising and bleeding. […] The symptoms of immune thrombocytopenia can be very different for different individuals. In general, the severity of symptoms will vary according to how far the platelet count is below the normal range. […] Common symptoms include fatigue, bruising that is unexpected or unusually severe, petechiae rash of tiny red or purple spots, purpura red or purple discoloured spots on the skin, prolonged or excessive bleeding from cuts, nosebleeds, bleeding gums, black blisters in the mouth, and for female patients, heavy periods. […] Fatigue is one of the main symptoms of ITP reported by patients. Various studies show that at least half of people living with ITP experience fatigue that can often interfere with everyday life.

• #32 Immune thrombocytopenia (ITP) | disease | symptoms | Sobi

  https://www.sobi.com/en/sobi-itp-immune-thrombocytopenia

  The fatigue experienced by people with autoimmune diseases such as ITP is different from the normal, temporary fatigue we all feel after a taxing activity such as concentrating for a long time or vigorous exercise, or after a poor night’s sleep. […] People living with ITP may worry about how bleeding could affect their work and social activities. For most people, the impact of ITP on their quality of life seems to reduce after the first year. […] Many of those living with ITP report impacts on their emotional wellbeing, with emotional and mental stress and anxiety, and a greater risk of depression.

• #33 Immune Thrombocytopenia (ITP) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/thrombocytopenia-and-platelet-dysfunction/immune-thrombocytopenia-itp

  Immune thrombocytopenia usually results from development of an autoantibody directed against a structural platelet antigen. These antiplatelet antibodies lead to increased platelet destruction, usually in the spleen, and inhibition of platelet production and release from megakaryocytes. […] Although often asymptomatic and identified only by a low platelet count on a routine assay, when present the symptoms and signs of immune thrombocytopenia include […] Petechiae […] Purpura and/or ecchymoses […] Mucosal bleeding […] Increased menstrual bleeding […] Fatigue […] Cognitive dysfunction. […] The spleen is of normal size unless it is enlarged by a coexisting viral infection or autoimmune hemolytic anemia (Evans syndrome). Like the other disorders of increased platelet destruction, ITP is also associated with an increased risk of thrombosis.

• #34 Symptoms of Immune Thrombocytopenia | Everyday Health

  https://www.everydayhealth.com/immune-thrombocytopenia/symptoms/

  Immune thrombocytopenia, also called ITP, is a disorder of the blood in which there is a shortage of platelets, or blood cells that are responsible for normal clotting, according to MedlinePlus. […] But when platelet levels are too low, bleeding can occur both internally and externally. […] Symptoms may begin to appear when platelet levels are very low. According to the National Organization for Rare Disorders (NORD), symptoms of ITP can include: Bruising or purple spots on the skin that occur very easily or for no known reason. These bruises are called purpura and may also appear in the mouth. […] ITP can cause any or all of these symptoms. […] According to the Platelet Disorder Support Association (PDSA), the excessive bleeding that comes with ITP can lead to anemia, a condition characterized by low levels of red blood cells. […] Mental health issues such as depression and anxiety are also common in people with ITP, the PDSA reports. […] In rare cases, ITP can lead to a brain bleed, or intracranial hemorrhage, according to NORD. […] An intracranial hemorrhage is a medical emergency and can be fatal.

• #35 Thrombocytopenia (Low Platelet Count): Causes, Symptoms, and Treatment Options

  https://www.webmd.com/a-to-z-guides/thrombocytopenia-symptoms-causes-treatments

  Thrombocytopenia Treatment […] There are many treatment options for thrombocytopenia. If it’s mild, you might not need any treatment. You’ll need to work with your doctor to weigh the pros and cons of each and find a therapy that’s right for you. The treatment will depend on what type of thrombocytopenia you have and what’s causing it. […] If your thrombocytopenia is drug-induced, stopping your medicine may help. If you have ITP and the trouble is with your immune system, your treatment depends on how severe a case you have. If it’s mild, you may only need to get regular checks of your platelet levels. […] When you do need treatment, the goal is to get your platelet count up enough to prevent serious bleeding in your gut or brain. You may need a platelet transfusion if there is immediate life-threatening bleeding. You may only get treatment when you have symptoms. But it’s possible your doctor could suggest treatment even when you feel fine. That’s more likely if you’re at high risk for bleeding or other complications.

• #36 Thrombocytopenia Symptoms, Diagnosis and Treatment

  https://www.bannerhealth.com/services/hematology/thrombocytopenia

  Thrombocytopenia is a condition that affects your blood. It can make you bruise easily or bleed more after an injury. […] If you have thrombocytopenia, your blood may not clot properly, and you may bleed more than usual after an injury or surgery. In severe cases, this can lead to internal bleeding, including bleeding in your brain, which can be life threatening. […] Some people with mild thrombocytopenia may not have any symptoms. When symptoms appear, they can include: Easy bruising, Small red or purple dots on the skin (petechiae), Splotches of reddish-purple (purpura), Bleeding gums or other areas in the mouth, Nosebleeds, Blood in urine, stool, mucus and/or vomit, Heavy menstrual periods. […] People with severe thrombocytopenia may have an increased risk of internal bleeding and heart attack. It may cause gastrointestinal bleeding or bleeding in your brain. Thrombocytopenia may decrease the amount of blood flow to your heart. […] If you notice any signs of bleeding, it’s important to get medical care right away.

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