Today we spoke about a case of thrombocytopenia.
The differential includes:
Decreased Production:
Problem with Bone marrow ability to produce platelets because of toxicity (meds, chemotherapy, alcohol), infection (viral, TB), replacement (cancer, fibrosis, amyloid/ sarcoid), or nutrition (folate and B12 deficiency)
Sequestration:
Secondary to portal hypertension or primary hypersplenism. Note: the counts do not drop below around 50k if this is the only cause
Destruction/Consumption:
Mechanical (prosthetic valves, malignant HTN), Immune (HIT, ITP), consumptive (TTP, DIC)
Itp is typically a 'diagnosis of exclusion' but the new guidelines don't require a bone marrow for everyone. A thorough history and physical exam need to be done!
Here is a REVIEW article on ITP.
This is a recent Commentary on ITP with the updates in management.
This is a very easy read of the new guidelines!
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