Taipei City Government

A 42-year-old woman suffered from gingival bleeding and oral mucosal bleeding when brushing her teeth one day, which was accompanied by subcutaneous purpura, bruising and punctate hemorrhage across the whole body and limbs. She hurried to the hospital for emergency treatment. The blood sampling found that her blood platelet count was only 3000/ml (the normal range is 150,000 - 400,000/ml), while her hemoglobin and white blood cell were normal, so she was hospitalized for further examination.
The bone marrow aspiration cytologic examination result showed that the count of megakaryocyte, namely the parent cells of the blood platelets, only rose slightly, while the parent cell series of other white blood cells and red blood cells were normal. The patient was diagnosed as suffering from primary (idiopathic or immunological) thrombocytopenic purpura; blood platelet transfusion and steroid injection were administered.
Three days later, the count of blood platelets was still around 8,000, so intravenous injection of immunoglobulin was administered, and the blood platelet count rose to 150,000 after one week. There was no more subcutaneous and oral bleeding and the patient was successfully discharged from the hospital.
Li Zhi-yu, director of the Hematology and Oncology Department in the Zhongxiao Branch of Taipei City Hospital, says that normal blood platelet range is between 150,000 to 400,000/ml. The blood vessels will be under pressure and prone to bleed when the blood platelet count is less than 20,000/ml. When undergoing surgical operation or tooth extraction, at least 80,000/ml or more blood platelets are needed to prevent continuous bleeding after the surgery. Sometimes, when the count of blood platelets is normal or even as high as 600,000 to 700,000/ml yet continuous or uncontrollable bleeding occur during tooth extraction, then abnormal platelet function can be suspected.
In addition, Director Li reminds the public that the administration of anti-platelet drugs (antiaggregant) such as aspirin and plavix must be stopped one week before tooth extraction or a surgical operation.