Evaluation of Thrombocytopenia

Posted by e-Medical PPT Wednesday, September 22, 2010
Thrombocytopenia is the presence of relatively low platelets in blood.In human beings a normal platelet count ranges from 150,000 to 450,000 platelets per 1ml of blood.Often, low platelet levels do not lead to clinical problems rather, they are picked up on a routine full blood count. Occasionally, there may be bruising, particularly purpura in the forearms,petechia (pinpoint hemmorages on skin and mucous membranes) nosebleeds and/or bleeding gums.If the person's platelet count is between 30,000 and 50,000/mm3, bruising with minor trauma may be expected; if it is between 15,000 and 30,000/mm3, spontaneous bruising will be seen.
Decreased platelet counts can be due to a number of disease processes.
Decreased production
* Vitamin B12 or folic acid deficiency
* Leukemia or myelodysplastic syndrome
* Decreased production of thrombopoietin by the liver in liver failure.
* Sepsis, systemic viral or bacterial infection
* Dengue fever can cause thrombocytopenia by direct infection of bone marrow megakaryocytes as well as immunological shortened platelet survival
* Hereditary syndromes
Fanconi anemia
Bernard-Soulier syndrome, associated with large platelet
Alport syndrome
Increased destruction
* Idiopathic thrombocytopenic purpura (ITP)
* Paroxysmal nocturnal hemoglobinuria (PNH)
* Neonatal alloimmune thrombocytopenia
* Hypersplenism
* HIV-associated thrombocytopenia

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