Thrombocytopenia & Infiltrative Diseases

Thrombocytopenia is a condition where there is a decrease in the platelet count resulting to prolonged bleeding. Infiltrative diseases are relatively rare but may induce the occurrence of thrombocytopenia as it causes invasive lesion to the bone marrow resulting to cytopenia diseases. The invasion of infiltrative diseases affects the red blood cell producing ability of the bone marrow and reduces its blood clotting mechanism.

Significance

• Infiltrative diseases may produce invasive lesions to the bone marrow resulting to varying forms of cytopenia, one of which is thrombocytopenia. It may result to the occurrence of anemia, neutropenia and pancytopenia as well. As infiltrative diseases cause bone marrow destruction, it results to significant risk to infection and bleeding.

Infiltrative Diseases Causing Thrombocytopenia

• Leukemia and infiltrative neoplasia are among the most common infiltrative diseases that can effect decreased platelet production resulting to thrombocytopenia. Leukemia can destroy the homeopathic cells that produce red blood cells as it damages the bone marrow. Infiltrative neoplasia may induce the replacement of the bone marrow with cancer cells thereby curtailing the bone marrow's ability to produce enough platelet and red blood cells.

Signs and Symptoms

• Decreased platelets in thrombocytopenia manifest with easy bruising, pinpoint sized reddish purple spots on the lower legs, prolonged bleeding during injury, and blood in the urine and stools. Symptoms of infiltrative diseases include oddly firm muscles due to deposition of connective tissue, cough and fever in cases of pneumonia (pulmonary infiltrates). Systemic signs may also be present like fatigue, weight loss and signs of malabsorption (loose bowel movement and presence of fat in stools).

Complications

• The biggest risk of severe thrombocytopenia is bleeding into the brain or digestive tract, which although rare, can be life-threatening. Infiltrative diseases does not usually result to life threatening disease unless with complications such as renal failure, presence of renal calculi, severe pneumonia and neurologic deficits.

Treatment

• Treatment of thrombocytopenia includes administration of corticosteroids, immunoglobulin, cyclophosphamide, blood transfusion, exchange transfusion and in cases of increased splenic sequestration surgery is indicated. Effective treatment management for thrombocytopenia is to treat the underlying causes such as infiltrative diseases as leukemia and neoplasm.

Considerations

• Certain medications can cause a thrombocytopenic reaction affecting the immune system that causes it to destroy platelets. Examples of these medications include heparin, quinidine, quinine, sulfa-containing antibiotics, some oral diabetes drugs, gold salts and rifampin.

  Most patients under glucocorticod therapy for infiltrative diseases manifest toxicity leading to steroid-sparing alternatives. Chemotherapy treatment for infiltrative neoplasma destroys the bone marrow during the treatment process thereby exacerbating its inability to produce red blood cells and platelets.