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Thrombocytopenia Differential Diagnosis

Differentiating the diseases that can cause thrombocytopenia:

Category	Condition			Clinical manifestations										Para−clinical findings								Gold standard	Associated findings
				Symptoms							Signs
														Lab Findings							Imaging
				Severity	Fever	Bleeding					BP	Other		CBC	PBS	Coagulopathy
			Mechanism
Infection	Gestational thrombocytopenia
	Chronic liver disease
	portal hypertension
	Hypersplenism
	Immune thrombocytopenia		Antibody-mediated platelet destruction	Moderate to severe	-																	Diagnosis of exclusion
	Congenital platelet disorders	MYH-9 related disorders
		Bernard-Soulier syndrome
		Gray platelet syndrome
		Wiskott-Aldrich syndrome
		Thrombocytopenia with absent radius (TAR) syndrome
		Alport syndrome
		Von Willebrand disease
	Viral infections	rubella, mumps, varicella, parvovirus, hepatitis C, and Epstein-Barr virus
		HIV	Direct toxicity to megakaryocytes An ITP-like condition called primary HIV-associated thrombocytopenia (PHAT) Secondary opportunistic infections
	Bacterial infections	Sepsis	Direct bone marrow suppression
		Helicobacter pylori	Immune thrombocytopenia
		Leptospirosis, brucellosis, anaplasmosis, and other tick-borne infections
	Intracellular parasites	Malaria
		Babesiosis
Medications/toxicity	Drug-induced immune thrombocytopenia	Antibiotics Sulfonamides Ampicillin Piperacillin Vancomycin Rifampin Older antiepileptic agents carbamazepine Phenytoin Quinine	Occurrence of drug-dependent, platelet-reactive antibodies
	Heparin-induced thrombocytopenia
	Cytotoxic chemotherapy
	Radiation therapy		Predictable, dose-dependent myelosuppression
	OTC agents	Quinine-containing beverages
	Alcohol
	Malignancy
	Nutrient deficiencies	folate, vitamin B12, copper	an autoimmune mechanism	Mild
	Thrombotic microangiopathy (TMA)	Thrombotic thrombocytopenic purpura (TTP)
		Hemolytic uremic syndrome (HUS)
		Drug-induced TMA (DITMA)
Bone marrow disorders	Myelodysplastic syndromes
	Aplastic anemia
	Acute leukemia
	Paroxysmal nocturnal hemoglobinuria (PNH)
Rheumatologic/autoimmune disorders	Systemic lupus erythematosus (SLE)
	Antiphospholipid syndrome (APS)		autoantibody-mediated syndrome
	Felty's syndrome		splenomegaly
vascular	giant capillary hemangioma,		platelet destruction
	large aortic aneurysms,		platelet destruction
	cardiopulmonary bypass		platelet destruction
	Post-transfusion purpura		immune-mediated platelet destruction