Last updated: Saturday, 05, February, 2011
|Key Information||Appropriate Tests|
The blood film should be examined in all cases of thrombocytopaenia and the platelet count repeated. A repeat count on a specimen collected in citrate may confirm EDTA associated clumping.
In vitro clumping of platelets is common in the presence of EDTA, leading to spurious thrombocytopaenia. Similarly, a partly clotted sample can lead to a falsely low result.
FBC, blood film.
Bone marrow aspiration may be required if mechanism and/or cause is not obvious from clinical and/or blood film findings or if confirmation is required.
See Neonatal bleeding under Bleeding disorder
See under Immunodeficiency
Amegakaryocytic thrombocytopenia with absent radii.
Increased destruction, margination, or loss
Immune - Autoimmune
Lymphoproliferative disorder associated, especially
Drug induced, especially
Platelet antibody testing (for drug dependent antibodies) may be helpful.
|<p>The commonest of the drug related causes of immune thrombocytopaenia.|
Viral infection associated, especially
EBV and CMV serology may be indicated.
HIV serology should be checked in all cases of suspected immune thrombocytopenia.
Immune - Alloimmune
Platelet antibody testing and platelet antigen typing of parents.
Post transfusion purpura
Platelet antibody testing and platelet antigen typing on recipient and blood donors.
This is a common cause of thrombocytopenia. Abnormal liver function tests may be helpful, however normal LFT's do not exclude the diagnosis. Imaging of the spleen by ultrasound or liver-spleen scan is recommended.