The treatment of thrombocytopenia is largely dependent upon the cause and the severity of the condition.
Some situations may require specific or emergency treatments, whereas others can be managed by occasional blood draws and monitoring of the platelet levels.
In autoimmune thrombocytopenia, or ITP, steroids can be used to weaken the immune system in order to impair the attack on platelets. In more severe cases, intravenous immunoglobulins or antibodies may also be given to slow down the immune process. In refractory cases, splenectomy (removal of the spleen) may be necessary.
If a drug is thought to be the cause of low platelet count, then it may be discontinued by the supervising physician. In patients with heparin induced thrombocytopenia, it is very important to remove and avoid the future use of any heparin products, including low molecular weight heparin (Lovenox), immediately to prevent further immune response against the platelets.
If thrombotic thrombocytopenic purpura or hemolytic uremic syndrome is diagnosed, the treatment may include plasma exchange or plasmapheresis. In cases of severe kidney failure, dialysis may be necessary.
In general, platelet transfusion is not necessary, unless an individual with low platelets (less than 50,000) has active bleeding or hemorrhage, or needs surgery or other invasive procedures. Sometimes, transfusion may be recommended without any bleeding if the platelet count is less than 10,000.
In suspected cases of HIT or TTP, transfusion of platelets is generally not recommended because the new platelets can potentially make the condition worse and more prolonged.
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Archived: March 20, 2014
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