Doctors use several tests and examinations to diagnose thrombocytopenia, including:
• Complete Blood Count (CBC) to measure platelet levels
• Peripheral blood smear to examine platelets under a microscope
• Physical examination to look for bruising, petechiae (tiny spots on skin), enlarged spleen, or bleeding
• Bone marrow testing to determine whether platelet production is reduced
• Additional blood tests to identify autoimmune disease, infections, or other underlying causes
Although many other conditions can also lower platelet counts, the underlying cause can also be used to determine the specific condition. Treatment options for thrombocytopenia depend on the patient’s platelet count, severity of the symptoms, and the underlying cause. Most lupus patients with mild thrombocytopenia do not require treatment and are monitored for progression.
For more severe cases, treatments options may include:
• Corticosteroids to reduce immune system activity
• Intravenous immunoglobulin to temporarily increase platelet counts
• Rituximab, a biologic therapy that targets B cells involved in autoimmune disease
• Thrombopoietin receptor agonists that stimulate platelet production
• Platelet transfusions for dangerously low platelet counts or active bleeding
• Splenectomy, or removal of the spleen, if other treatments are unsuccessful
Researchers are also studying newer therapy techniques that target platelet activation and immune cell interactions, which may provide additional treatment options for lupus-associated thrombocytopenia in the future.
If you have lupus and thrombocytopenia, your healthcare provider may recommend changes to reduce bleeding risk, such as:
• Avoiding contact sports or activities with a higher risk of injury
• Limiting use of medications like aspirin, ibuprofen, or other medications that interfere with platelet function
• Limiting alcohol consumption, which can also lead to reduced platelet production
• Report any new bruising, bleeding, or symptoms to your healthcare provider
