When we apply to health institutions due to various health problems we experience, some blood tests are requested. Among these blood tests, especially the test called complete blood count or hemogram stands out. With complete blood count, the amount, various characteristics, and competencies of the cells in our blood are measured, and valuable information about many systemic health problems, especially hematological diseases, is obtained. One of the values examined in the complete blood count examination, which includes various parameters such as hemoglobin, leukocyte, and MCHC, is the platelet or platelet count.
It is very important to know the causes of the health problems we experience and what we should do in the best way to protect and improve our health. In this sense, having general and sufficient information about blood tests also contributes to our communication with our physicians; It also gives us valuable ideas about the measures we need to take in the name of our health.
What are platelets?
Platelets, platelets, or blood platelets; It is one of the cellular elements found in our blood such as red and white blood cells. Thrombocytes are cell fragments formed by the breakdown of cells called megakaryocytes in the bone marrow tissue located in the center of our bones as they pass into the blood after maturing.
Platelets play an important role in the regulation of certain chemical reactions that occur in the blood, thanks to their biochemical content. However, their main function is in case of bleeding as a result of blood vessel injury; It is the early closure and repair of the wound area. In case of injury, certain changes occur in the outer parts of the platelets and they interact with both the scar tissue and other platelets to form a temporary plug that closes the wound. In the meantime, it accelerates the formation of the clot by contributing to the coagulation process required for long-term wound closure and healing. Likewise, it also helps to contract the blood vessel wall to reduce the amount of bleeding during all these processes. With all these features, platelets are indispensable elements for preventing and stopping bleeding and healing wound tissues. About this, blood vessels become susceptible to injury if platelets fall below a certain number. The bleeding that occurs cannot be stopped and the wound becomes difficult to heal.
What is the normal range of platelets?
In a healthy person, the platelet value should be between 150,000 and 450,000 cells/ml as a result of a complete blood count. If the platelet value falls below 150,000, it is mentioned that there is a low platelet count called thrombocytopenia. If this value is detected above 450,000, the situation is called thrombocytosis and the thrombocyte height is detected.
What do low platelets mean?
Low thrombocyte or thrombocytopenia may develop due to many underlying diseases, as well as in diseases directly related to thrombocytes. In this sense, a decrease in the number of platelets can be observed through two mechanisms:
Decreased platelet production: Platelets are produced in the bone marrow as megakaryocytes. Like other blood cells, the production of platelets is regulated under the control of certain hormones and biochemical substances. Accordingly, in case of damage to the bone marrow, suppression of thrombocyte production in the bone marrow, or a decrease in the number of regulatory hormones and substances, thrombocyte production is also interrupted and the number of platelets decreases.
Increased platelet destruction: Platelets are destroyed in various body tissues such as the spleen and new ones are produced as they age or lose function, just like other blood cells. In various diseases, this destruction process of platelets is accelerated or directly destroyed in the blood or tissues. In these cases, the number of platelets decreases.
Dilution of blood: Since the complete blood count calculates the number of cells compared to the blood fluid, if the fluid ratio of the blood increases, the normal number of platelets can be detected as low.
What are the causes of low platelets?
Health problems that cause thrombocytopenia can be listed as follows:
- Vitamin B12 or folic acid deficiency: The production of blood cells is impaired, leading to a decrease in the number of platelets as well as severe anemia.
- Pregnancy: As the platelet destruction increases, the fluid ratio of the blood increases and dilutes, so the amount of thrombocytes is low.
- Medication side effects: Some drugs cause thrombocytopenia by disrupting platelet production.
- Aplastic anemia: In this condition, which can also be expressed as the failure of the bone marrow, thrombocyte production decreases significantly.
- Previous blood transfusions: Platelets may be destroyed due to antibodies formed during the transfusion of blood from other donors.
- Blood poisoning (Sepsis): As a result of the blood being infected by bacteria, thrombocytes are rapidly destroyed.
- Certain viral infections: Certain viral infections such as chickenpox, EBV or HIV increase the destruction of platelets.
- Some immunological disorders: In auto-immune diseases such as idiopathic thrombocytopenic purpura or in some rheumatological disorders, the destruction of thrombocytes in the spleen is accelerated.
- Hypersplenism (Overwork of the spleen): The enlargement and overwork of the spleen due to various diseases cause rapid destruction of thrombocytes in the blood.
- Poisoning with some toxic substances and radiation: In cases of accumulation of some toxic substances such as lead and benzene in the body or exposure to intense radiation, the production of thrombocytes decreases by suppressing the bone marrow.
- Alcohol consumption: Long-term alcohol consumption causes a decrease in the number of platelets.
- Hematological cancers: Leukemias and some lymphomas result in impaired bone marrow function and platelet production is interrupted.
- Bone marrow diseases: Production of platelets is reduced in various bone marrow diseases such as myelofibrosis or myelodysplasia.
- Chronic diseases: Chronic diseases of various systems in the body affect the number of platelets that may lower.
What symptoms are seen in low platelets?
As the amount of platelets decreases, various clinical symptoms occur. The presence and severity of these symptoms occur in direct proportion to the decrease in the amount. In other words, the lower the platelet count, the more severe and serious clinical pictures occur. In this sense, the following symptoms suggest low platelets:
- Red, purple, or brown bruises in the contact areas of the body, especially the arms and legs (purpura)
- Color changes consisting of small red or purple spots (petechiae)
- Recurrent nosebleeds
- Bleeding gums
- Prolonged and profuse menstrual bleeding
- Prolonged or non-stop bleeding in case of injury
- Blood from the anus or urine
- When the amount of thrombocyte drops seriously, life-threatening internal bleeding may develop in the body, and, accordingly, conditions such as cerebral hemorrhage, bloody urine, bloody stool, or blood vomiting may occur.
What does the platelet elevation mean?
In the case of increased platelet count or thrombocytosis, there is the opposite of the mechanisms that cause low platelets. Accordingly, the existence of one of the following situations is considered:
Increase in thrombocyte production: The number of thrombocytes increases, especially in the case of increased hormones and chemicals involved in the regulation of blood cells or in various bone marrow tumors.
Decrease in thrombocyte destruction: In cases such as removal of the spleen, which is the main destruction site of platelets, the life span of thrombocytes increases, and the number in the blood increases.
The concentration of blood: If the fluid ratio of the blood decreases, the thrombocyte count can be detected relatively high in the complete blood count.
What are the causes of platelet elevation?
Thrombocytosis can be observed in healthy people, as well as a harbinger of some health problems. Accordingly, the amount of thrombocyte is found to be high in the complete blood count in the following cases:
- Physiological overproduction: The presence of various genetic factors increases the number of platelets in some individuals.
- Iron deficiency: Since the decrease in the number of iron results in a decrease in the number of red blood cells in the bone marrow, the amount of platelets also increases due to the increased hormones to accelerate production.
- Removal of the spleen: In people whose spleen is removed for various reasons, the destruction of thrombocytes slows down,, and its amount increases.
- Bleeding: In the presence of active bleeding in the body, the production is accelerated because of the loss of red blood cells. As a result, the amount of platelets also increases.
- Destruction of red blood cells (hemolysis): Just like active bleeding, the number of platelets increases in parallel with the reduction of red blood cells.
- Chronic diseases: In some rheumatologically based chronic diseases (inflammatory bowel diseases, inflammatory rheumatism, etc.), an increase in the platelet count can be detected.
- Some bone marrow cancers: In some types of bone marrow cancer such as essential thrombocytosis, the amount of platelets increases significantly.
What symptoms are seen with platelet height?
The increase in the number of platelets generally does not cause any clinical symptoms or complaints. It is often detected incidentally during routine complete blood count. In addition, thrombocytosis can be seen during the investigation of other underlying diseases. Apart from these, the platelet count, which increases significantly, may cause the following symptoms:
- Defect of vision
- Weakness – tiredness
- Swelling, redness, and burning sensation in hands and feet
- Size in the spleen
- Easy bruising and bleeding
What to do with low or high platelets?
Planning the treatment method for the increase or decrease in the platelet count primarily depends on the correct diagnosis of the underlying disease. Accordingly, a detailed medical history is taken by a specialist physician and a detailed physical examination is performed. Then, when necessary, a diagnosis is made by referring to imaging and additional blood tests. Treatment planning varies depending on the number of platelets and the disease detected at the diagnosis.
In the case of mild thrombocytopenia, the physician may not deem additional treatment necessary and recommend only follow-up. Apart from this, treatment is planned to eliminate the underlying health problem. However, in more severe cases, some lifestyle changes are recommended, such as avoiding activities that cause injury, not exercising and sports, using protective equipment to prevent injury, choosing a soft toothbrush, ending alcohol consumption, and stopping drugs that disrupt platelet functions. In addition, when necessary, administration of platelet products or prescribed drugs such as corticosteroids or immunoglobin to reduce platelet destruction; In addition, treatment methods such as the surgical removal of the overworked spleen come to the fore.
For thrombocytosis, the presence of the patient’s active complaint and the detection of the underlying disease are very important. Although follow-up is often followed without treatment, in severe thrombocyte elevations, methods such as medication or thrombogenesis can be used.
Considering all these, when a change in your platelet amount is detected, you can apply to the nearest health institution for a specialist’s assessment. Wishing you healthy days.
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