Thrombocytopenia is an abnormal decrease in the number of blood platelets, which can lead to excessive bleeding and/or bruising.

The causes of thrombocytopenia may be due to failed platelet production, reduction of platelets originating in the spleen, increased platelet destruction, and use or dilution of platelets.

Signs and symptoms may include:

• abnormal bleeding with a sudden onset manifested by: petechiae or ecchymosis in the skin, or bleeding into mucous membranes

• malaise

• fatigue

• general weakness

• lethargy

• large, blood-filled blisters in the mouth.

Other signs and symptoms may include:

• fever

• enlarged spleen

• chronic liver disease presented by spider angiomas

• jaundice

• palmar erythema.

• persons with HIV may have thrombocytopenia

Tests conducted may include: blood cell count, bone marrow aspiration, antiplatelet, and antibody studies. A comprehensive history is taken to rule out: drugs known to increase platelet destruction; the possible history of a blood transfusion administered within ten previous days; significant alcohol consumption; any underlying immunologic disorders such as arthralgia and Raynaud's syndrome, (see Diagnostic Code: 7117 Raynaud's syndrome); or unexplained fever.

Treatment may include: removal of the causative agents if drug-induced, and proper treatment of the underlying causes. Treatment may also include: removal of the spleen (see Diagnostic Code: 7706 Splenectomy); chemotherapy for acute or chronic leukemia; and steroids, or intravenous immune globulin and oral corticosteroid for idiopathic thrombocytopenic purpura (ITP). Platelet transfusion may also be given to reduce the risk of spontaneous bleeding.

Residuals will depend on the person's response to treatment of the underlying cause. If the treatment involved a splenectomy, the person has an increased risk for infection. Leukocytosis and thrombocytosis occur after the removal of the spleen, and may last for years. Long-term steroid therapy may be indicated. Exposure to trauma and infection need to be avoided, as well as taking aspirin products. The person should be cautioned about the possible side effects of prolonged steroid therapy, which may include acne, moon face, hirsutism, buffalo hump, hypertension, obesity about the waist, thinning arms and legs, glycosuria, and swelling.

• None.

• Separately evaluate splenectomy under diagnostic code 7706 and combine with an evaluation under this diagnostic code.

• A 100 percent evaluation shall continue beyond the cessation of chemotherapy. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any reduction in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 CFR 3.105(e).