Thrombocytopenia means that there aren’t enough platelets in the blood. Platelets (or thrombocytes) are very small cells that help the blood clot and heal the body from injuries.

If you have lupus, you’re more likely to develop thrombocytopenia because your immune system attacks healthy platelets. Talk with your doctor if you’re worried about thrombocytopenia.

What are the symptoms of thrombocytopenia?

When thrombocytopenia is mild, it may not cause any symptoms. When thrombocytopenia does cause symptoms, they’re usually related to bleeding. Symptoms may include:

• Bleeding that lasts for a long time — even from small cuts
• Small, red spots on the skin
• Easy bruising
• Nosebleeds or bleeding gums
• Blood in urine (pee) or stool (poop)  
• Very heavy periods
• Fatigue (feeling very tired) 

What causes thrombocytopenia?

Thrombocytopenia has many possible causes, but people with lupus usually get it because their immune systems mistakenly attack and destroy blood platelets.

Thrombocytopenia can also happen when:

• Your body doesn’t make enough platelets to begin with
• Platelets get trapped in your spleen (an organ that protects you from infections) because of another health condition, lowering the number of platelets in your blood
• Drugs like cytoxan, mycophenolate and azathioprine may cause thrombocytopenia because they suppress the production of platelets in the bone marrow.

How will my doctor check for thrombocytopenia?

Usually, the doctor will do a complete physical exam and ask questions about the symptoms you’re having and your medical history. They may also order tests to check your blood or bone marrow.

What are the treatments for thrombocytopenia?

Most people with lupus who have thrombocytopenia don’t need treatment. If you do need treatment, your doctor may recommend:

• Medicines that increase platelet count or weaken the immune system
• Treatments that suppress lupus activity will increase platelets
• Many people get help with rituximab (a biologic that depletes B cells)
• Blood or platelet transfusion
• Surgery to remove the spleen (splenectomy)