Thrombocytopenia
Bruising, particularly purpura in the forearms and petechiae in the feet, legs, and mucous membranes, may be caused by spontaneous bleeding under the skin.[12] Abnormally low platelet production may be caused by:[13] Abnormally high rates of platelet destruction may be due to immune or nonimmune conditions, including:[15] These medications can induce thrombocytopenia through direct myelosuppression:[16] Laboratory tests for thrombocytopenia might include full blood count, liver enzymes, kidney function, vitamin B12 levels, folic acid levels, erythrocyte sedimentation rate, and peripheral blood smear.[citation needed] In severe thrombocytopenia, a bone marrow study can determine the number, size, and maturity of the megakaryocytes.This information may identify ineffective platelet production as the cause of thrombocytopenia and rule out a malignant disease process at the same time.[26] Treatment of thrombotic thrombocytopenic purpura (TTP) is a medical emergency, since the associated hemolytic anemia and platelet activation can lead to kidney failure and changes in the level of consciousness.The plasmapheresis procedure also adds active ADAMTS-13 protease proteins to the patient, restoring a normal level of von Willebrand factor multimers.The threshold for treating ITP has decreased since the 1990s; hematologists recognize that patients rarely spontaneously bleed with platelet counts greater than 10,000/μL, although exceptions to this observation have been documented.These agents had previously shown promise, but had been found to stimulate antibodies against endogenous thrombopoietin or lead to thrombosis.Romiplostim (trade name Nplate, formerly AMG 531) was found to be safe and effective for the treatment of ITP in refractory patients, especially those who relapsed following splenectomy.[36] In the case of infection, polymerase chain reaction tests may be useful for rapid pathogen identification and detection of antibiotic-resistance genes.
SpecialtyHematologyDiagnostic methodComplete blood countimmunosuppressantsplatelet transfusionsurgical removal of the spleenplateletsbleedingcoagulation disorderintensive care patientsthrombocythemiathrombocytosisseptic shockhas no symptomsnosebleedsperiodsBruisingpurpurapetechiaemucous membranesred blood cellswhite blood cellsecchymosesmalaisefatiguebullaeDehydrationvitamin B12folic acidLeukemiamyelodysplastic syndromeaplastic anemiathrombopoietinliver failureSepsisbacterial infectionLeptospirosisBernard–Soulier syndromegiant platelet disorderCongenital amegakaryocytic thrombocytopeniaEpstein syndromeFanconi anemiaGlanzmann's thrombastheniaGray platelet syndromeHarris platelet syndromeMay–Hegglin anomalyParis-Trousseau thrombocytopeniaJacobsen syndromeThrombocytopenia absent radiusUpshaw–Schulman syndromeWiskott–Aldrich syndromeX-linked thrombocytopeniaImmune thrombocytopenic purpuraThrombotic thrombocytopenic purpuraHemolytic–uremic syndromeDisseminated intravascular coagulationParoxysmal nocturnal hemoglobinuriaAntiphospholipid syndromeSystemic lupus erythematosusPost-transfusion purpuraNeonatal alloimmune thrombocytopeniaHypersplenismDengue feverGaucher's diseaseZika virusValproic acidMethotrexateCarboplatinInterferonIsotretinoinPanobinostatH2 blockersproton-pump inhibitorsSnakebiteLyme diseaseThrombocytapheresisNiemann–Pick diseasefull blood countliver enzymeskidney functionerythrocyte sedimentation ratebone marrow biopsyspleen enlargementfolate deficiencymegakaryocyteshematologistCorticosteroidsLithium carbonatePlatelet transfusionshemolytic anemiaplasmapheresisantibodiesvon Willebrand factorproteaseADAMTS-13proteinshematologistsendogenousthrombosisRomiplostimrelapsedHeparin-induced thrombocytopeniadirect thrombin inhibitorlepirudinargatrobanblood thinnersbivalirudinfondaparinuxWarfarinBiomedical Advanced Research and Development AuthorityU.S. Department of Health and Human Servicesnecrotizing enterocolitispolymerase chain reactioncytomegalovirusrubella virusStaphylococcusEnterococcusStreptococcus agalactiaeListeria monocytogenesEscherichia coliHaemophilus influenzaeKlebsiella pneumoniaePseudomonas aeruginosaYersinia enterocoliticaCandida