Thrombocytopenia history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Thrombocytopenia}} | {{Thrombocytopenia}} | ||
{{CMG}} | {{CMG}}, '''Associate Editor(s)-in-Chief:''' [https://www.wikidoc.org/index.php/User:Farbod_Zahedi_Tajrishi <nowiki>Farbod Zahedi Tajrishi, M.D. [2]</nowiki>] | ||
==Overview== | ==Overview== | ||
Since a broad spectrum of conditions can result in [[thrombocytopenia]], an accurate history could be of great benefit in identifying the cause. The history should be thorough and include the patient's present [[Symptom|symptoms]], past medical history, [[Family history|family]] and social history as well as any history of [[Blood transfusion|transfusion]], [[:Category:Drugs|drug]]/chemical/[[radiation]] exposure or recent travel to areas that are [[Endemic (epidemiology)|endemic]] to certain [[Infection|infections]]. | |||
[[Symptom|Symptoms]] of [[thrombocytopenia]] are mainly specific to the underlying cause of the condition. Many patients may even be [[asymptomatic]]. However, common findings among [[symptomatic]] patients include the ones related to [[bleeding]] (eg, [[Gastrointestinal bleeding|blood in stool]], [[easy bruising]], [[Epistaxis|nosebleeds]], abnormal [[menstruation]], etc.) and [[Weakness (medical)|weakness]] or [[fatigue]]. | |||
==History == | ==History == | ||
A thorough history is essential to an effective evaluation of [[thrombocytopenia]]. While some of the conditions leading to [[thrombocytopenia]] can be immediately diagnosed, others may require specific or repeated questioning. In addition to a well-investigated present illness, a precise past medical history can help a great deal to identify the cause of [[thrombocytopenia]]. The history should include questions about:<ref name="pmid24267279">{{cite journal| author=Greenberg EM, Kaled ES| title=Thrombocytopenia. | journal=Crit Care Nurs Clin North Am | year= 2013 | volume= 25 | issue= 4 | pages= 427-34, v | pmid=24267279 | doi=10.1016/j.ccell.2013.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24267279 }}</ref><ref name="pmid15481750">{{cite journal| author=Patel U, Gandhi G, Friedman S, Niranjan S| title=Thrombocytopenia in malaria. | journal=J Natl Med Assoc | year= 2004 | volume= 96 | issue= 9 | pages= 1212-4 | pmid=15481750 | doi= | pmc=2568454 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15481750 }}</ref><ref name="pmid10559451">{{cite journal| author=West KA, Anderson DR, McAlister VC, Hewlett TJ, Belitsky P, Smith JW et al.| title=Alloimmune thrombocytopenia after organ transplantation. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 20 | pages= 1504-7 | pmid=10559451 | doi=10.1056/NEJM199911113412004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10559451 }}</ref> | |||
* [[Bleeding]] (eg, [[Petechia|petechiae]], [[Ecchymosis|ecchymoses]], [[epistaxis]], [[Gingiva|gingival]] bleeding, [[hematemesis]], [[melena]], [[menorrhagia]]) | |||
* Other symptpms such as [[fever]], [[Rash|rashes]], [[pain]] (eg, in bone), [[headache]], or vision changes | |||
* Recent travel ([[dengue fever]], [[malaria]], [[rickettsial infections]], [[Tick-borne disease|tick bite]], [[leptospirosis]], [[meningococcemia]], [[Hantavirus infection|Hantavirus]], [[Ebola]], [[Lassa fever]] | |||
* Recent hospitalizations/ [[Vaccination|immunizations]] | |||
* Any previous illnesses (esp. [[Hematologic diseases|hematologic]] and [[Rheumatologic disease|rheumatologic]]) and recent [[Infection|infections]], [[Cancer|malignancies]] (eg, [[myelodysplastic syndrome]], [[leukemia]], [[lymphoma]], [[aplastic anemia]]) | |||
* [[Pregnancy]] | |||
* [[Blood transfusion|Transfusions]] | |||
* [[Organ transplant]] | |||
*<nowiki/>Medications ([[aspirin]], [[Non-steroidal anti-inflammatory drug|NSAID]]<nowiki/>s, [[heparin]], [[Low molecular weight heparin|LMWH]], etc.)/ [[Herb|herbs]]/ chemicals/ [[Radiation (medicine)|radiation]] | |||
* Family history of bleeding <nowiki/>disorders and/or [[thrombocytopenia]]. ('''Note:''' Negative family history does not rule out the possibility of genetic [[Etiology|etiologies]] because some individuals with familial platelet disorders remain undiagnosed well into adulthood.) | |||
* Dietary habits (eg, vegetarianism) | |||
* High-risk behaviors ([[Human Immunodeficiency Virus (HIV)|HIV]], [[hepatitis]]) | |||
* Alcohol/ drug use | |||
==Symptoms== | ==Symptoms== | ||
Thrombocytopenia usually has no symptoms and is picked up on a routine full blood count (or complete blood count). Symptomatic patients may experience:<ref name="pmid24267279" /> | |||
* | * Easy bruising | ||
* | * Bleeding symptoms (eg, those indicative of [[Petechia|petechiae]], [[purpura]], [[Ecchymosis|ecchymoses]], [[epistaxis]], [[Gingiva|gingival]] bleeding, [[hematemesis]], [[melena]], [[menorrhagia]]) | ||
* | * Malaise, fatigue and general weakness | ||
==References== | |||
{{reflist|2}} | |||
[[Category:Hematology]] | |||
{{ | |||
{{WS}} | |||
{{WH}} | |||
Latest revision as of 23:56, 19 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Farbod Zahedi Tajrishi, M.D. [2]
Overview
Since a broad spectrum of conditions can result in thrombocytopenia, an accurate history could be of great benefit in identifying the cause. The history should be thorough and include the patient's present symptoms, past medical history, family and social history as well as any history of transfusion, drug/chemical/radiation exposure or recent travel to areas that are endemic to certain infections.
Symptoms of thrombocytopenia are mainly specific to the underlying cause of the condition. Many patients may even be asymptomatic. However, common findings among symptomatic patients include the ones related to bleeding (eg, blood in stool, easy bruising, nosebleeds, abnormal menstruation, etc.) and weakness or fatigue.
History
A thorough history is essential to an effective evaluation of thrombocytopenia. While some of the conditions leading to thrombocytopenia can be immediately diagnosed, others may require specific or repeated questioning. In addition to a well-investigated present illness, a precise past medical history can help a great deal to identify the cause of thrombocytopenia. The history should include questions about:[1][2][3]
- Bleeding (eg, petechiae, ecchymoses, epistaxis, gingival bleeding, hematemesis, melena, menorrhagia)
- Other symptpms such as fever, rashes, pain (eg, in bone), headache, or vision changes
- Recent travel (dengue fever, malaria, rickettsial infections, tick bite, leptospirosis, meningococcemia, Hantavirus, Ebola, Lassa fever
- Recent hospitalizations/ immunizations
- Any previous illnesses (esp. hematologic and rheumatologic) and recent infections, malignancies (eg, myelodysplastic syndrome, leukemia, lymphoma, aplastic anemia)
- Pregnancy
- Transfusions
- Organ transplant
- Medications (aspirin, NSAIDs, heparin, LMWH, etc.)/ herbs/ chemicals/ radiation
- Family history of bleeding disorders and/or thrombocytopenia. (Note: Negative family history does not rule out the possibility of genetic etiologies because some individuals with familial platelet disorders remain undiagnosed well into adulthood.)
- Dietary habits (eg, vegetarianism)
- High-risk behaviors (HIV, hepatitis)
- Alcohol/ drug use
Symptoms
Thrombocytopenia usually has no symptoms and is picked up on a routine full blood count (or complete blood count). Symptomatic patients may experience:[1]
- Easy bruising
- Bleeding symptoms (eg, those indicative of petechiae, purpura, ecchymoses, epistaxis, gingival bleeding, hematemesis, melena, menorrhagia)
- Malaise, fatigue and general weakness
References
- ↑ 1.0 1.1 Greenberg EM, Kaled ES (2013). "Thrombocytopenia". Crit Care Nurs Clin North Am. 25 (4): 427–34, v. doi:10.1016/j.ccell.2013.08.003. PMID 24267279.
- ↑ Patel U, Gandhi G, Friedman S, Niranjan S (2004). "Thrombocytopenia in malaria". J Natl Med Assoc. 96 (9): 1212–4. PMC 2568454. PMID 15481750.
- ↑ West KA, Anderson DR, McAlister VC, Hewlett TJ, Belitsky P, Smith JW; et al. (1999). "Alloimmune thrombocytopenia after organ transplantation". N Engl J Med. 341 (20): 1504–7. doi:10.1056/NEJM199911113412004. PMID 10559451.