Do I Need Therapy for a Low Platelet Level?

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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Do I Need Therapy for a Low Platelet Level?

Advocate (12/13/94) No. 670, P. 37
Cohan, Gary R.

Immune thrombocytopenia (ITP)--very low platelet counts-- affects from 3 to 12 percent of people infected with HIV and 30 to 60 percent of people with full-blown AIDS. Infection with HIV can cause impaired production of platelets or their destruction by platelet antibodies. Alcohol and certain medications--such as aspirin, Dilantin, and heparin--can also contribute to the problem. While bleeding may occur in any part of the body when there is a critical shortage of platelets--usually less than 20,000--bleeding seldom occurs in the gastrointestinal tract, where major hemorrhaging can be fatal. Because of the toxicity and expense, available therapies may or may not be worth their sometimes questionable effectiveness. Aggressive treatments should be reserved for patients with significant bleeding problems. Oral medications such as AZT and danazol have been studied as treatments. Therapies using intravenous immune globulin, vincristine, or subcutaneous alpha-interferon should be restricted to those patients who do not respond to the oral medications. Spleen- removal surgery is a final option if platelet counts cannot be maintained above 20,000 with medications.

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