Thrombocytopenia is a condition that causes low numbers of platelets (thrombocytes). Platelets are blood cells that help the blood to form clots and stop bleeding. If a person has too few platelets, they can bleed or bruise more easily.
Low platelet counts often happen as a side effect of chemotherapy, radiation therapy, certain medications, and other treatments.
A normal platelet count range is 150,000 to 400,000 per microliter of blood. But this can depend on your child's age. Ask your care team what a normal platelet count is for your child.
Platelet Count Range
What it Means
150,000 – 450,000 / microliter
Normal platelet count
50,000 – 100,000 / microliter
Minor risk for bleeding with injury
Less than 50,000 / microliter
Increased risk of bleeding with injury, surgery, or certain procedures
Less than 20,000 / microliter
At risk for spontaneous bleeding
Less than 10,000 / microliter
At risk for serious bleeding
Platelet counts are given as the number of platelets per microliter (µL) of blood.
These ranges are general guides. Your child’s bleeding risk may depend on their diagnosis, symptoms, medicines, and overall health. Always consult your care team for information about specific test results and what they mean.
Symptoms of thrombocytopenia
Mild thrombocytopenia may not cause noticeable symptoms. Or, your child may bruise more easily or bleed longer after a cut or injury.
Other signs and symptoms of thrombocytopenia include:
Feeling tired, especially if your child also has bleeding or anemia
Nosebleeds
Bleeding gums
Heavy menstrual periods or periods that last longer than normal
Blood in urine (pee)
Stool (poop) that is black or bloody
Blood in vomit
Bleeding from the vagina when not having a menstrual period
Bad headaches
Vision changes
Feeling confused or sleepier than usual
Purpura: bruising or purplish spots on the skin, lips, or inside the mouth
Petechiae: small red or purple “pinpoint” dots on the skin that may look like a rash
Tell your care team right away if your child shows any new or worsening signs of bleeding.
Petechiae are flat, rash-like dots on the skin due to bleeding.
Causes of thrombocytopenia
Thrombocytopenia is a common side effect of medical treatments, like chemotherapy, radiation, and certain medicines. It can also happen after blood loss from injury or surgery.
Thrombocytopenia is diagnosed based on your child’s medical history, physical exam, and lab tests. Your care team may ask you about any changes in bleeding or bruising, recent illnesses, or medicines your child is taking.
Blood clotting tests (also called a coagulation panel) to see how well your child's blood clots and how long it takes
Your care team may do other tests to look for other medical conditions or underlying causes of bleeding.
Treatment of thrombocytopenia
Not all children need treatment for low platelets. Your care team will check your child’s blood counts and monitor symptoms to see when and if treatment is needed.
If thrombocytopenia happens as a treatment side effect, platelet counts will usually return to normal after your child’s treatment is complete.
Treatments for thrombocytopenia include:
Treating the cause: For example, if low platelets are caused by a medical condition, treating that condition may help platelet counts improve.
Platelet transfusion: A transfusion of donor platelets can be given through a vein to increase platelet count and help prevent or control bleeding.
Medicines: Your care team might prescribe medicines to help the body make more platelets, decrease the immune response, or control bleeding.
Splenectomy: Surgery to remove the spleen might be used if other treatments don’t work. This is only used in certain conditions and is rare in children.
How to manage thrombocytopenia
When your child’s platelet counts are low, it is important to take steps to prevent bleeding and bruising.
Avoid certain medicines and supplements. This includes over-the-counter drugs like aspirin and ibuprofen, which can increase bleeding risk. Ask your care team for a list of what to avoid.
Brush teeth gently with a soft toothbrush.
Avoid activities or sports that have a higher risk of falls or injury.
Do not take your child’s temperature rectally.
Have your child wear shoes, even when inside.
Be extra careful when using sharp objects. If your child is older, they should use an electric razor to shave.
Use lotion and lip balm to prevent dry skin and chapped lips.
Be sure your child does not pick at scabs or pimples.
Females who have a menstrual cycle should ask their care team whether tampons are safe to use. Sanitary pads may be recommended when platelet counts are very low or bleeding is heavy.
How to treat minor bleeding at home
Daily activities can cause bleeding or bruising. Use the following tips to care for your child at home.
Minor cuts and wounds: Use a clean cloth to apply pressure to the wound until bleeding stops. Clean the wound with soap and water. Dry the area and apply a sterile bandage or gauze.
Bleeding in the mouth or gums: Rinse your child’s mouth with ice or cold water. Follow your care team’s instructions for oral care to help prevent bleeding gums.
Nosebleeds: To help stop a nosebleed, have your child sit up straight and lean slightly forward. Pinch the soft part of the nose with the thumb and finger and hold gentle, steady pressure for 10–15 minutes. Release pressure slowly to see if bleeding has stopped.
Bruising: Apply ice to the area for about 20 minutes.
When to call your care team
Seek medical care right away if your child has:
Bleeding that will not stop
Blood in vomit or stool
Severe headache
Confusion
Unusual sleepiness
Vision changes
A head injury
Questions to ask the care team
What is the cause of my child’s low platelet count?
What is my child’s risk of bleeding?
What should we do if my child has a nosebleed, cut, or other bleeding at home?
How often will my child need tests to monitor their platelet counts?
Should my child avoid certain activities while their platelet counts are low?
Are there any medicines, supplements, or over-the-counter products my child should avoid?
Are there other precautions to take to prevent bleeding?
What signs of bleeding should we watch for?
When should we call the care team, and when should we seek emergency medical care?
Key points about thrombocytopenia
Thrombocytopenia, or low platelets, is a common side effect of some treatments including chemotherapy, radiation therapy, and certain medicines.
Thrombocytopenia can also be caused by an underlying medical condition.
If your child has low platelet counts, they can bleed or bruise more easily.
Most thrombocytopenia is temporary and may not need treatment. Your care team will let you know what tests and treatment your child needs.
Talk to your care team about how to reduce your child’s risk of bleeding and what to do if bleeding occurs.
A low ANC (neutropenia) refers to having low levels of neutrophils in the blood. Learn how neutropenia or low “counts” increases the risk of infection.
