Thrombocytopenia resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Introduction

Thrombocytopenia refers to relatively few platelets in blood. A normal platelet count ranges from 150,000 to 450,000 per microliter of blood, determined by the 2.5th lower percentile of the normal platelet count distribution.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• Disseminated intravascular coagulation

Common Causes

• Bone marrow suppression (for example chemotherapy, irradiation)
• Chronic alcohol use
• Chronic liver disease
• Congenital thrombocytopenia
• Disseminated intravascular coagulation
• Drug-induced thrombocytopenia
• Gestational thrombocytopenia
• HELLP syndrome
• Hemolytic uremic syndrome
• Heparin-induced thrombocytopenia
• Immune thrombocytopenic purpura
• Infections
• Preeclampsia
• Pseudothrombocytopenia
• Thrombotic thrombocytopenic purpura

Management

Shown below is an algorithm summarizing the approach to thrombocytopenia.