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Thrombocytopenia - Medical Malpractice
Thrombocytopenia is defined as any blood disorder in which there is a low number of platelets. Platelets are the parts of the blood that control blood clotting within the blood vessels and in situations where you start bleeding due to an injury or cut. In fact, without enough platelets, you can begin to bleed spontaneously.
Thrombocytopenia can be caused by one of three things: It can be caused by not enough platelets created in the bone marrow. It can be caused by platelets being used up inside the body, especially within the blood vessels. Finally, it can be caused by sequestration and breakdown of platelets in either the spleen or the liver (or both). All result in a low platelet count when the blood is drawn for platelets and all can cause serious bleeding complications.
A lower than average production of platelets in the bone marrow can be caused by conditions like bone marrow cancer or other cancers that have settled in the bone marrow, aplastic anaemia, cirrhosis of the liver, deficiency of folate, bone marrow infections, myelodysplasias and vitamin B12 deficiency. Some drugs can contribute to low platelet production in the bone marrow. Chemotherapy is an example of having a low platelet count due to bone marrow suppression by the drugs used to treat cancer.
Conditions that result in the breakdown of platelets within the blood vessels include DIC or "disseminated intravascular coagulation" and drug induced non-immune thrombocytopenia. There is also a condition called drug induced immune thrombocytopenia that has similar symptoms but is related to the immune response to the platelets as a result of the drug exposure.
Other conditions that result in thrombocytopenia due to rapid uptake of platelets include hypersplenism, immune thrombocytopenic purpura or ITP and thrombotic thrombocytopenic purpura. The latter disease results in excessive thrombosis in the body with the platelets getting chewed up in the clotting process.
The main symptoms of thrombocytopenia include recurrent or obvious multiple bruises, nose bleeds or bleeding within the mouth or on the gums. You can have a petechial rash from bleeding underneath the first layer of skin. More serious symptoms of thrombocytopenia include gastrointestinal bleeding or bleeding within the brain. Serious symptoms can sometimes be the first sign of a case of thrombocytopenia. A normal platelet count is between 150,000 and 400,000. You can begin to get bleeding complications below a platelet count of 50,000 and serious bleeding is possible with a platelet count of less than 20,000 or 15,000. You can have mild thrombocytopenia and not have any obvious symptoms.
Doctors diagnose thrombocytopenia by means of a complete history and physical examination. The spleen may be enlarged, which can be a clue that the platelets are being segregated. A complete blood count can show low platelets as well as low haemoglobin and low white blood cell counts, depending on the cause of the disease. A bone marrow biopsy can be done as long as it is safe and can occur without an undue amount of bleeding. If the problem is in making platelets at an insufficient amount, the bone marrow biopsy will show a lack of platelet making cells.
The doctor can also check for platelet associated antibodies, which indicate that an immune disease is the cause of the low platelet count.
The treatment of the low platelet count depends on the cause. Stem cell transplants can help in cases of aplastic anaemia. Immune fighting medications like prednisone can be given to reduce the immune response that sometimes occurs with thrombocytopenia. In some cases, the doctor must remove the spleen so that it cannot abnormally sequester the platelet cells.LEGAL HELPLINE: ☎ 855 804 7125