Does alcohol consumption cause thrombocytopenia (low platelet count)?

From the Guidelines

Thrombocytopenia does not cause alcohol, but rather, alcohol consumption can lead to thrombocytopenia, a condition characterized by abnormally low platelet counts in the blood. According to the most recent study 1, alcohol can suppress bone marrow function and interfere with platelet production, directly damaging the bone marrow where platelets are made and shortening the lifespan of existing platelets in circulation. This can result in easy bruising, prolonged bleeding from cuts, spontaneous nosebleeds, or bleeding gums. The severity of alcohol-induced thrombocytopenia typically correlates with the amount and duration of alcohol consumption.

Some key points to consider in the evaluation of thrombocytopenia include:

• The patient's history, including bleeding symptoms, type and severity of bleeding, and duration of bleeding 1
• Physical examination findings, such as signs of liver disease, lymphadenopathy, or splenomegaly 1
• Laboratory tests, including complete blood counts and blood smears to confirm thrombocytopenia and rule out pseudothrombocytopenia 1
• The potential impact of lifestyle factors, such as alcohol consumption, on platelet count and overall health 1

In terms of management, stopping alcohol consumption is essential to improve platelet counts and prevent further complications. The study 1 highlights the importance of considering the patient's overall health status and the potential risks and benefits of anticoagulation therapy in patients with advanced liver disease. However, in the context of alcohol-induced thrombocytopenia, the primary focus should be on addressing the underlying cause of the condition, rather than solely on managing its symptoms.

From the Research

Thrombocytopenia and Alcohol

• Thrombocytopenia is defined as a platelet count less than 150,000/μL 2
• Causes of thrombocytopenia include infections, malignancy, liver disease, autoimmune disorders, disseminated intravascular coagulation, pregnancy, medications, and coagulation disorders 2
• Alcohol use can cause thrombocytopenia, with the condition being generally benign and clinically significant hemorrhage being rare 3
• The platelet count begins to rise after 2 to 5 days' abstinence from alcohol 3

Alcohol-Induced Thrombocytopenia

• Alcohol-induced thrombocytopenia is a decrease in the platelet count below 150,000 in a microliter of blood 4
• The phenomenon of thrombocytopenia related to heavy drinking began to arouse interest in the 1960s and 1970s 4
• Relationships between alcohol use, its intensity and occurrence, and intensity of thrombocytopenia have been demonstrated 4
• The risk of occurrence of withdrawal seizures or delirium tremens in alcohol withdrawal syndrome increases significantly when the platelet count is less than 119,000/μL 4

Thrombocytopenia Treatment

• Treatment for thrombocytopenia is determined by the underlying cause of the thrombocytopenia 2
• Romiplostim and eltrombopag are two relatively new drugs that have been shown to be successful in immune thrombocytopenia treatment after standard treatment failure 5
• These medications seem to be a largely effective, safe option, with romiplostim appearing to have slightly fewer adverse effects and higher costs 5