What are the differences between thrombocytopenia and hemophilia?

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Although thrombocytopenia and hemophilia cause similar symptoms, they are two different conditions.

Thrombocytopenia occurs when a person has a platelet count lower than 150,000 platelets per microliter of blood. Hemophilia occurs when a person lacks or has low levels of clotting factor proteins.

Hemophilia generally affects males and rarely affects females. Thrombocytopenia does not affect more of one sex than another.

There are two main types of hemophilia, called hemophilia A and hemophilia B. Each type affects a different clotting factor protein. Hemophilia A affects clotting factor VIII, whereas hemophilia B affects clotting factor IX. Both types cause blood clots to form slowly or not at all, which may lead to excessive bleeding.

The severity of a person’s hemophilia can depend on how much clotting factor they have. The less clotting factor in their blood, the more severe their symptoms.

Thrombocytopenia affects the number of platelets a person has. If a person has low platelet levels, they may bleed excessively when injured, as blood clots form more slowly. Very low platelet levels can cause serious bleeding.

No, neither hemophilia nor thrombocytopenia can cause the other condition. However, rarely, a person may have both conditions.

A review from 2017 noted that some people who have hemophilia may also have reduced platelet activity. As the platelets may not function normally, this could contribute to problems with clot formation. However, the author notes limited research currently, and it requires further study.

Hemophilia is usually an inherited condition. It occurs when a child inherits a gene variation from their parents. For hemophilia, a person inherits this gene alteration through the X chromosome. A chromosome is a strand of DNA that contains information packets, known as genes, inherited from a person’s parents.

Females have two X chromosomes and males have one X and one Y chromosome. This is why males are more likely to inherit hemophilia, as a female would have to inherit two copies of the gene variation to have the disease.

A person can either inherit or acquire thrombocytopenia. Acquiring a condition means a person may not be born with it, but can develop it later due to various factors.

Thrombocytopenia may occur as a result of the following factors:

• exposure to toxic chemicals
• drinking too much alcohol, which can cause platelet levels to drop temporarily
• certain medications
• aplastic anemia, a rare blood disorder
• autoimmune diseases, such as lupus
• cancers, such as leukemia or lymphoma
• conditions that cause blood clots, such as thrombotic thrombocytopenic purpura (TTP)
• infections, which can temporarily reduce platelet levels
• having a larger than normal spleen, which may store too many platelets

Hemophilia and thrombocytopenia share certain symptoms while others differ. The following table shows some common symptoms of both conditions.

Different treatment options are available for hemophilia and thrombocytopenia.

Treatments for hemophilia

Doctors treat hemophilia by replacing the missing clotting factor in a person’s blood. This involves a healthcare professional injecting a person with clotting factor concentrates.

If a person has severe hemophilia, they may need to inject themselves with the clotting factor every few days. This helps prevent bleeding episodes. If a person with hemophilia needs to undergo a medical procedure, such as surgery, injecting clotting factors may also be necessary to prevent excessive bleeding.

A doctor may prescribe certain medications to treat a person who has mild hemophilia. These can include amino caproic acid, which can prevent blood clots from breaking down, and desmopressin, which releases clotting factors in the blood vessels.

Treatments for thrombocytopenia

A person who has mild thrombocytopenia may not experience any symptoms and therefore, require no treatment.

Treatments for symptomatic thrombocytopenia may depend on the cause of the condition. By treating the underlying cause, a doctor can help reduce a person’s symptoms.

Medications

If a person is taking medications that cause thrombocytopenia, a doctor may change it for another.

A doctor may prescribe a person immunosuppressants if their immune system is destroying their platelets.

Other potential medications a doctor may prescribe to treat thrombocytopenia include corticosteroids, eltrombopag, or romiplostim. These medications may help improve platelet counts.

Procedures

A person may require a transfusion or splenectomy if medications do not help their symptoms.

A blood or platelet transfusion can treat a person who is bleeding heavily or has a high risk of bleeding. It involves a healthcare professional inserting an intravenous (IV) line into a person’s vein. The person then receives blood or platelets into their vein.

A splenectomy is a surgery to remove the spleen. If a person’s spleen is retaining too many platelets, a splenectomy can help improve platelet levels.

Hemophilia and thrombocytopenia are both conditions that affect how a person’s blood clots. Hemophilia occurs due to a lack of effective clotting proteins known as clotting factors. Thrombocytopenia occurs due to a low number of platelets, which are a type of blood cell that helps form blood clots.

Although they have similar symptoms, they are two different conditions. A person should consult a doctor if they experience symptoms of either condition, such as excessive bleeding, easy bruising, and blood being present in the stool or urine.