Causes of Thrombocytopenia and Platelet Disorders - ...
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Causes of Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup

History:

 - Prior platelet count, family history

 - Medications

 - Chronicity/severity

 - History of bleeding (petechiae, ecchymoses, epistaxis, gingival bleeding, hematemesis, melena, heavy menstrual  

 - Recent procedures

 - Infection exposure (l MD SOAP)

 - Risks factor for HIV, HCV

 - Alcohol use

 - Dietary practices that could cause nutrient deficienies

Labs:

 - Basic labs for decreased PLT count: CBC(.plateletcount), peripheral blood smear, HIV/HCV testing

 - Lab for decreased PLT in selected cases: INR/PT, aPTT(liver disease, decrease vit K), H. pylori test (GI symptoms/endemic country), thyroid function test, ANA (e.g., SLE), anti-phospholipid antibodies, Quantitative IgA, IgG, IgM (CVID, WAS), (neurologic/psychiatric changes), high MCV anemia (vegan, gastric bypass), LFT (liver disease), HBsAg/anti-HBc (rituximab tx candidate)

 - Bone marrow evaluation: not required in all patients with thrombocytopenia. However, it may be helpful in some patients if the cause of thrombocytopenia is unclear, or if a primary hematologic disorder is suspected. When do you do a BM aspiration/biopsy? Refractory ITP, unexplained pancytopenia, dysplasia on the smear



Dr. Jorge Cortés @Jcortesizaguirr



#Thrombocytopenia #Platelet #Disorders #Differential #Diagnosis #Causes #Workup #hematology
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