Platelet disorders
Platelets are small, essential blood cells that help stop bleeding and start the repair process when blood vessels are damaged. In platelet function disorders, however, these cells don’t work as they should, leading to issues with blood clotting and increased risk of bruising or bleeding. Here, we’ll explore how normal clotting works, how platelet disorders disrupt this process, and the types and impacts of these disorders.
How does clotting work normally?
When a blood vessel is injured, the body initiates a four-stage process to form a clot and prevent blood loss:
- Stage 1: Blood vessel damage leads to bleeding.
- Stage 2: Blood vessels constrict, reducing blood flow to the area.
- Stage 3: Platelets adhere to the blood vessel walls and release substances that attract other platelets, forming a plug at the injury site (platelet adhesion and aggregation).
- Stage 4: Platelets activate clotting proteins, creating a fibrin clot through the coagulation cascade.
Types of Platelet Function Disorders
Platelet function disorders can impact clotting in several ways:
Adhesion issues: Platelets fail to stick to vessel walls (e.g., Bernard-Soulier Syndrome).
Aggregation issues: Platelets don’t clump together to form a plug (e.g., Glanzmann Thrombasthenia).
Activation issues: Platelets don’t trigger blood proteins to form a fibrin clot.
These issues are classified into hereditary disorders, which run in families, and acquired disorders, which result from other conditions or medications.
Common types of hereditary Platelet Disorders
Hereditary disorders are further grouped based on how platelets fail to function:
Platelet adhesion disorders: (e.g., Bernard-Soulier Syndrome) where platelets can’t stick to vessel walls.
Platelet aggregation disorders: (e.g., Glanzmann Thrombasthenia) where platelets can’t clump at the injury.
Platelet secretion disorders: Issues with substances released by platelets that help clotting.
Procoagulant disorders: (e.g., Scott Syndrome) where platelets don’t support clot formation on their surface.
Symptoms and diagnosis
Most people with platelet function disorders experience mild symptoms, and some may not notice any issues unless they experience a significant injury or undergo surgery. However, in rare cases, these disorders can lead to severe bleeding. It’s essential for healthcare providers to be informed of any known platelet function disorder before a patient undergoes dental procedures or surgeries.