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
