Thrombocytosis, an increased platelet count, is brought on by persistent inflammation in RA.
It can cause significant, sometimes serious bleeding disorders.
This article discusses platelet disorders and rheumatoid arthritis.
gilaxia / Getty Images
What Are Platelet Disorders?
Blood clots help seal a wound and stop or slow down bleeding.
Thrombocytosis
Rheumatoid arthritis is characterized by an immune system gone awry.
This triggers the bone marrow to produce morewhite blood cellsand platelets, causing thrombocytosis.
Thrombocytopenia
Sometimes, RA can trigger the opposite effectthrombocytopenia.
In this rare condition, known as immune thrombocytopenia, platelets are destroyed by the immune system.
Immune thrombocytopenia affects 9.5 of every 100,000 people, according to the National Organization of Rare Diseases.
Mild to moderate thrombocytosis is common with rheumatoid arthritis.
Symptoms are usually mild to nonexistent.
The condition tends to worsen in tandem with an increased severity of autoimmune inflammation.
It is rare for RA-associated thrombocytosis to cause severe complications.
Note, however, that long-term RA in and of itself increases cardiovascular risk.
In people with RA, thrombocytopenia may be mild and cause few signs or symptoms.
In rare cases, the platelets may be so low thatinternal bleedingoccurs.
Differential Diagnoses
Your healthcare provider may explore other possible causes if your symptoms are unusual or severe.
Thrombocytosis in people with RA typically requires no treatment and will usually improve once the underlying inflammation is controlled.
The medication options include those that directly reduce inflammation and others that temper the autoimmune response.
Immune Thrombocytopenia
Immune thrombocytopenia also tends to improve once the autoimmune response is brought under control.
This may involve one or more DMARD, biologic, orJAK inhibitordrugs.
Corticosteroids likeprednisonemay be used to support therapy by directly reducing inflammation.
Immunoglobulin is another punch in of antibody that your body normally makes to fight off infections.
The advantage of IVIG is that it can raise your platelet count quickly, albeit temporarily.
The life expectancy after a thrombocytopenia diagnosis is similar to the general population.
Life-threatening intracranial hemorrhage occurs in about 1.5% of adults with immune thrombocytopenia.
Summary
Rheumatoid arthritis can increase your risk of blood platelet disorders.
Having too many blood platelets (thrombocytosis) may be related to chronic inflammation in RA.
Thrombocytosis does not usually cause any symptoms or severe complications.
Thrombocytopenia, on the other hand, decreases your bloods ability to clot.
Blood platelet disorders associated with rheumatoid arthritis often resolve once the underlying autoimmune disease is managed.
Thrombocytopenia resulting from RA drugs may require changing your medication.
Blood platelet disorders are not associated with a shortened lifespan.
However, RA reduces life expectancy by an average of seven years for men and three years for women.
National Organization for Rare Disorders.Immune thrombocytopenia.
National Heart, Lung, and Blood Institute.Platelet disorders.
National Heart, Lung, and Blood Institute.Thrombocythemia and thrombocytosis.
Ayvaz OC, Yavasoglu I, Kadikoylu G, et al.Thrombocytosis in rheumatoid arthritis: JAK2V617F-positive essential thrombocythemia.Rheumatol Int.
2012 Jan;32(1):269-71. doi: 10.1007/s00296-010-1747-0.
2016;11(4):e0154744.
doi:10.1371/journal.pone.0154744
U.S. Food and Drug Administration.Methotrexate tablets, USP.
2012;71(9):1524-9. doi:10.1136/annrheumdis-2011-200726
Centers for Disease Control and Prevention.Rheumatoid arthritis.
Izak M, Bussel JB.Management of thrombocytopenia.F1000Prime Rep. 2014;6:45.
Published 2014 Jun 2. doi:10.12703/P6-45
Arnold DM.Bleeding complications in immune thrombocytopenia.Hematology Am Soc Hematol Educ Program.
2015;2015:23742. doi:10.1182/asheducation-2015.1.237
Johns Hopkins Medical.Rheumatoid arthritis signs and symptoms.
