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If you have recurring bleeding gums or bluish/reddish spots on your body, do get it checked. A low platelet count could be one of the causes. Today is Platelet Day, aimed at increasing awareness about these life-saving cells that facilitate blood clotting to stem bleeding.
Vinit Dhanu, 48, works with Larson & Toubro and holds a black belt in karate. Last February, after karate practice, he noticed black patches on his hands that refused to heal quickly. Tests revealed a low platelet count (13,000), and though he continues practising karate, he is careful to “avoid fights or anything that has potential to cause bleeding.”
Diagnosis, the key
A platelet count between 1.5 lakh and 4.5 lakh per microlitre of blood is considered normal, while anything below 10,000 is dangerous. Dr Rahul Bhargava, Consultant — Haematology and Bone Marrow-transplant, Medanta Medicity, Gurgaon, says, “There are several reasons why a patient can have a low platelet count, it could be due to dengue, a viral infection or Immune Thrombocytopenic Purpura (ITP). It is the most common confusion among doctors.”
While the platelet count tends to dip (medical term: thrombocytopenia) during a viral infection or dengue, it regains quickly once cured. But sometimes, the body's immune system creates antibodies that destroy platelets, leaving the person vulnerable to uncontrolled bleeding, and this condition is called ITP — which was the diagnosis for Dhanu.
Symptoms of ITP include red spots on the skin (due to internal bleeding) or bleeding gums and nose. The more serious conditions include increased bleeding during periods, blood in the urine and internal bleeding in the brain or intestine (blood in vomit).
Treatment
Steroids are used to treat ITP, and sometimes the spleen is removed to help increase the platelet count in a procedure called splenectomy.
Dr Biju George, Professor of Haematology at CMC Vellore, sees, on average, five patients a week with ITP. “Three months ago, I had a 19-year-old patient who was bleeding from the nose for a month, and it was diagnosed as ITP. He was put on drugs, and while he was taking treatment, his platelet count fell drastically. He came to the hospital unconscious and we discovered bleeding in the brain. After an emergency splenectomy, his platelet count hit a million soon after,” Dr George says.
Emphasising the need for preventive care, Dr Mukesh Desai, Chief of Immunology, Wadia Hospital, says, “If ITP becomes persistently chronic, you will need to live with it, like how you live with hypertension. Patients should avoid playing contact sports, to reduce chances of injury.”
More women get diagnosed, as the detection becomes easier due to excessive menstrual blood flow. “The ratio of women to men diagnosed is 1.3:1,” says Dr Bhargava.
A simple complete blood count (CBC) test is enough to measure platelet count. “The health culture in India is such that people avoid going to a doctor until there is major bleeding — there are no monthly or yearly check-ups,” says Dr George.
As misdiagnosis is a common problem, Dr Bhargava hopes to use Platelet Day to spread awareness among doctors through a series of lectures.
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