In many instances, thrombocytopenia may have no symptoms, especially if mild, and it can be detected only incidentally on routine blood work done for other reasons.
If thrombocytopenia is severe, for example less than 20 per micro liter, it can potentially manifest as increased bleeding when a person is cut or injured or increased bleeding during menstrual periods.
Spontaneous bleeding can also happen with severe thrombocytopenia (less than 10,000 to 20,000 platelets). This type of bleeding usually occurs under the skin or the mucous membranes (the inner lining of the oral cavity, gastrointestinal tract, or the nasal cavity).
Petechiae may be seen in patients with very low platelet counts. Petechiae are small (pinhead size) red, flat spots seen under the skin on the dependent parts of the body because of increased pressure due to gravity, for example, on the lower legs. These happen because of bleeding out of the tiny blood vessels under the skin or the mucous membranes. Petechiae are generally not palpable or painful.
Other rashes or bruises seen in thrombocytopenia are called purpura, which are small, purple spots under the skin as a result of hemorrhage. These are typically greater than 3 millimeters in diameter and may represent a confluence of petechiae.
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