Thrombocytopenia

Thrombocytopenia 

Updated: 08/03/2021

© Jun Wang, MD, PhD

General features
  • Platelet count below the lower limit of normal, either reduced production or increased destruction
  • Grades
    • Mild (platelet count 100-150 x 103/mm3)
    • Moderate (50-99 x 103/mm3)
    • Severe (<50 x 103/mm3)
  • Usually asymptomatic until platelet count <100 x 103/mm3
  • Surgical bleeding <50 x 103/mm3
  • Spontaneous bleeding <10 x 103/mm3
Clinical presentations
  • Asymptomatic, ISOLATED, incidentally-discovered thrombocytopenia
Common: Immune thrombocytopenia (ITP), Gestational thrombocytopenia during pregnancy
Less common: Occult liver disease, myelodysplastic syndrome, congenital thrombocytopenia, HIV infection
  • Symptomatic, severe thrombocytopenia
Drug-induced thrombocytopenia
Immune thrombocytopenia (ITP)
  • Thrombocytopenia as part of a multisystem illness
Common: Immune thrombocytopenic purpura, drug-induced thrombocytopenia, heparin-induced thrombocytopenia, liver disease, sepsis with disseminated intravascular coagulation (DIC), cancer with DIC, pregnancy [preeclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), abruptio placentae with DIC], multi-organ failure syndromes
Less common: Thrombotic thrombocytopenic purpura (TTP, acquired or hereditary), drug-induced thrombotic microangiopathy (DITMA), hemolytic uremic syndrome (HUS), lymphoma, acute leukemia, antiphospholipid syndrome, paroxysmal nocturnal hemoglobinuria (PNH), nutrient deficiency (vitamin B12, folate, copper)

Some thrombocytopenic disorders
  • Immune thrombocytopenia (ITP)
Acute immune thrombocytopenia
Chronic immune thrombocytopenia
  • Drug induced thrombocytopenia
Heparin induced thrombocytopenia



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