Thrombocytopenia and Hepatitis C

Thrombocytopenia is a blood disorder condition with a deficiency of platelets called thrombocytes, which increase the risk of bleeding. Platelets help your blood clot. Thrombocytopenia happens when the bone marrow makes fewer platelets or when too many platelets are destroyed or build up in an enlarged spleen.

Important facts for those with hep C

Thrombocytopenia is an extrahepatic complication that can occur in patients with hepatitis C. Thrombocytopenia with hepatitis C can be dangerous, particularly for patients with advanced liver disease, such as cirrhosis.

Thrombocytopenia can increase the risk of severe bleeding, especially during necessary tests and procedures, as well as other associated conditions. Another hepatic condition associated with advanced liver disease is portal hypertension, which is also associated with thrombocytopenia.

There is a risk for thrombocytopenia and portal hypertension that cause dilated blood vessels called varices; In the esophagus or stomach, this is known as variceal bleeding. If these blood vessels rupture, this can become life-threatening.

Symptoms of thrombocytopenia

Some of the symptoms of thrombocytopenia include...

• Excessive or easy bruising
• Prolonged bleeding from wounds or cuts
• Bleeding from your nose or gums
• Superficial bleeding into the skin that looks like a rash of pinpoint size reddish spots, this normally appears on the lower legs
• Blood in your urine or stools
• Thrombocytopenia will also show from blood work of your platelet count

What can be done

Your physician will need to determine the underlying cause for low platelet count and how low the platelets are. From there the best course of treatment can be considered.

Some treatment options include...

• Blood or platelet transfusion with packed red blood cells or platelets.
• Medications such as a corticosteroid or others to boost your platelet count depending on the cause of the condition.
• Surgical removal of the spleen if treatment options don’t help.
• Be given plasma if necessary.

If the patient has hepatitis C and advanced liver damage such as cirrhosis, necessary tests are done to determine if the patient has thrombocytopenia and portal hypertension. The physician can determine what course of treatment is best for thrombocytopenia prior to beginning treatment with direct-acting antiviral therapy for hepatitis C.

Once low platelet count is under control, usually, treatment for hepatitis C can proceed, but the patient will need to be closely monitored to make sure their platelet count is not dropping too low. If platelet count drops too low, hepatitis C treatment may need to be interrupted.

What you can do

If you have hepatitis C, talk to your physician about the condition of your liver and if you have cirrhosis. Ask about tests for portal hypertension, varies, and thrombocytopenia.

Keep a record of your blood work. If you don’t understand what a test is for, or test results, talk to your physician. Be proactive and learn what to look for in symptoms of thrombocytopenia and how to treat it.