Advanced liver disease often results in platelet dysfunction and bleeding. Platelet levels are often decreased in liver disease because an enlarged spleen traps platelets so they cannot reenter the bloodstream. In patients with a history of alcohol abuse, low platelet levels may be caused by the toxic effects of alcohol on platelet production in the bone marrow. Please see Liver Cancer . In dysproteinemia, increased blood levels of abnormal proteins interfere with normal platelet function.
Abnormal proteins are present in diseases such as multiple myeloma and macroglobulinemia.
Dysproteinemia and its underlying cause are diagnosed by physical examination and laboratory testing. Treatment involves addressing the underlying disease. Plasmapheresis, or plasma exchange, may be used to control bleeding. Vitamin B 12 and folate are necessary for platelet production. Deficiencies in either vitamin may lead to bleeding.