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Thrombocytopenia (Low Platelet Count) (cont.)

How is thrombocytopenia (low platelet count) diagnosed?

Low platelet count is often discovered incidentally during routine blood work. Platelets are a component of the complete blood count (CBC) along with white blood cell and red blood cell counts. Pseudothrombocytopenia can be eliminated by repeating the CBC.

Investigation for low platelet count includes a comprehensive medical history and physical examination by the doctor. Review of all the medications, family history, and personal history of cancers, drug and alcohol use, bleeding problems, and other medical conditions (rheumatic diseases, liver problems, kidney disease) needs to be included in this evaluation. An enlarged spleen (splenomegaly), petechiae, and purpura are typically looked for on the physical examination in these patients.

Further diagnostic investigation for thrombocytopenia relies on a detailed review of the other values on the CBC (red cell count, hemoglobin, white blood cell count, mean platelet volume or MPV), the comprehensive blood chemistry panel (kidney function, liver function, electrolytes), blood coagulation panel (other components of the clotting system), and review of the blood smear under the microscope (looking for fragmented red cells, shape and size of white cells, red cells, platelets).

Tests for antibodies and other assays may be performed in cases in which HIT or ITP are suspected. Bone marrow biopsy is sometimes done to evaluate for aplastic anemia, leukemia, lymphoma, or metastatic cancer to the bone marrow.

What is the treatment for thrombocytopenia (low platelet count)?

Patient Comments

The treatment for thrombocytopenia depends largely on its severity and the underlying cause.

For the most part, patients with thrombocytopenia do not require regular platelet transfusion. If any surgery or other invasive procedure is planned in a patient with a platelet count less than 50,000, then transfusion may be necessary to keep the platelet count greater than 50,000.

Other general recommendations for platelet transfusion are active bleeding in patients with platelet counts less than 20,000 to 50,000 (depending on the clinical picture) and patients with platelet counts less than 10,000 with or without active bleeding.

Medically Reviewed by a Doctor on 7/13/2016

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