Unexplained Anaemia and Thrombocytopenia
What is Unexplained Anaemia (UA)?
Unexplained anaemia (UA) is most often mild and detected incidentally. It is characterised by haemoglobin levels approximately 1 g/dL below the World Health Organization (WHO) threshold, without any clear underlying cause such as iron, vitamin B12, or folate deficiency, blood loss, or chronic disease.
Red blood cells are typically normocytic (normal in size), and blood smear findings show no evidence of intravascular haemolysis or dysplastic changes. Because the symptoms are subtle and laboratory values only mildly abnormal, UA may often go unnoticed during routine medical evaluations particularly in older adults.
What is Thrombocytopenia?
Thrombocytopenia refers to a low platelet count, which may impair the blood’s ability to form clots and increase the risk of bleeding. Platelets (thrombocytes) play a vital role in wound healing and maintaining vascular integrity.
A decreased platelet count can result from a range of physiological or pathological factors and may manifest with or without bleeding symptoms.
Possible Causes of Unexplained Anaemia and Thrombocytopenia
While both conditions may be labelled “unexplained” when no immediate cause is found, there are several recognised contributing factors.
Contributors to Thrombocytopenia:
- Genetic predisposition
- Autoimmune diseases (e.g., lupus, rheumatoid arthritis)
- Medications (e.g., heparin, chemotherapy)
- Excessive alcohol consumption
- Toxin exposure (e.g., arsenic, benzene)
- Viral or bacterial infections
- Splenic enlargement (sequestration of platelets)
- Pregnancy-related changes
- Mechanical destruction (during surgery or transfusions)
Contributors to Anaemia:
- Chronic or acute blood loss
- Menorrhagia (heavy menstrual bleeding)
- Nutrient deficiencies (iron, folate, vitamin B12)
- Chronic diseases (kidney disease, cancer, autoimmune conditions)
- Age-related decline in bone marrow function
Signs and Symptoms
Following are the signs and symptoms for:
Thrombocytopenia:
- Prolonged bleeding from minor injuries
- Petechiae (tiny red or purple spots on the skin)
- Purpura (larger areas of skin bleeding)
- Gum bleeding or nosebleeds
- Blood in urine or stool
- Excessive menstrual bleeding
Unexplained Anaemia:
- Fatigue or generalised weakness
- Pale or sallow skin
- Shortness of breath
- Dizziness or fainting
- Headaches
- Feeling cold
- Jaundice (in some cases)