Thrombocytopenia causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
There are two broad mechanisms for the causes of thrombocytopenia: Reduced platelet production and increased platelet destruction. Thrombocytopenia is seen in a variety of infectious and genetic disorders as well as a side effect of a large list of medications.
Causes
Life Threatening Causes
Common Causes
Causes by Organ System
Causes in Alphabetical Order
Decreased production
Vitamin deficiencies
- Vitamin B12 deficiency
- Folic acid deficiency
- Iron deficiency
Hematologic disorders
- Pancytopenia
- Aplastic anemia
- Acute lymphoblastic leukemia
- Acute myeloid leukemia
- Chronic lymphocytic leukaemia
- Chronic myeloid leukaemia
- Hairy cell leukaemia
- Myeloma
- Non-Hodgkin lymphoma
- Myelodysplastic syndrome
- Myelofibrosis
Reduced thrombopoiesis due to reduced thrombopoietin production
- Decreased production of thrombopoietin by the liver in liver failure.
Infectious etiologies
- Sepsis, systemic viral or bacterial infection
- Dengue fever can cause thrombocytopenia by direct infection of bone marrow megakaryocytes as well as immunological shortened platelet survival
- Protozoa and protozoal conditions
- Visceral leishmaniasis
- Human granulocytic ehrlichiosis
- Human monocytotropic ehrlichiosis
- Mycoplasma pneumonia
- Staphylococcal toxic shock syndrome
- Epstein-Barr virus
- Hantavirus
- HIV-1 disease
- Infectious mononucleosis
- Lassa fever
- Measles
- Mumps
- Oklahoma tick fever
- Rubella
- Severe acute respiratory distress syndrome
- Tick born encephalitis
Intrauterine acquired conditions
Hereditary syndromes
- Congenital Amegakaryocytic Thrombocytopenia (CAMT)
- Bernard-Soulier syndrome, associated with large platelets
- May-Hegglin anomaly, the combination of thrombocytopenia, pale-blue leuckocyte inclusions, and giant platelets
- Grey platelet syndrome
- Alport syndrome
Chromosomal abnormalities
Mendelian inherited conditions
- Autoimmune lymphoproliferative syndrome type 1
- Autoimmune lymphoproliferative syndrome type 2
- Radial aplasia-thrombocytopenia syndrome or Thrombocytopenia absent radius syndrome
- von Willebrand disease, platelet type
Autosomal dominant conditions
- Arias oculootoradial syndrome
- Complement factor H deficiency
- Fechtner syndrome
- May-Hegglin anomaly
- Platelet glycoprotein 4 deficiency
- Sebastian platelet syndrome
Autosomal recessive conditions
- Chediak-Higashi disease
- Dibasic aminoaciduria type 2
- Familial histiocytic reticulosis
- Fanconi anaemia
- Folate malabsorption hereditary
- Gaucher disease
- Griscelli syndrome type 1
- Histiocytosis X
- Holocarboxylase synthase deficiency
- Iminodipeptiduria
- Isovaleric acidaemia
- Methylmalonic aciduria type 2
- Neuroectodermal melanolysosomal disease
- Niemann-Pick disease type B
- Omenn syndrome
- Platelet glycoprotein Ib deficiency
- Propionyl-CoA carboxylase deficiency PCCA type
- Sea blue histiocytosis
- Shwachman-Diamond syndrome
X-linked inherited conditions
- GATA1-related cytopenia
- Immunodysregulation polyendocrinopathy and enteropathy, X-linked
- Wiskott-Aldrich syndrome
- X-linked hyperimmunoglobulin M syndrome
- Mitochondrial genome inherited conditions
- MELAS
Chemical exposure
- Strontium-89
- Zinc
Increased destruction
Hematologic Disorders
- Idiopathic thrombocytopenic purpura (ITP)
- Thrombotic thrombocytopenic purpura (TTP)
- Hemolytic-uremic syndrome (HUS)
- Disseminated intravascular coagulation (DIC)
- Paroxysmal nocturnal hemoglobinuria (PNH)
- Neonatal alloimmune thrombocytopenia (NAITP)
- Following transfusion or post transfusion alloimmune thrombocytopenia
- Evans syndrome
- Macrophage activation syndrome
Cardiovascular causes
- Cholesterol embolism
- Intraaortic balloon pump placement
- Endocarditis
Obstetric disorders
Autoimmunde Disorders
Infectious Disorders
- Dengue fever has been shown to cause shortened platelet survival and immunological platelet destruction
- HIV [2]
Other disorders
- Splenic sequestration of platelets due to hypersplenism
Medication-induced
Thrombocytopenia associated with medications can be due to either a reduction in production of platelets or increased destruction.
List of potential etiologies:
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Sulphonamides Drugs, hormones and mediators Aclarubicin Anazolene Antithymocyte globulin Arsenic trioxide
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Guanidinium Haem arginate Methyldopate
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Para-amino salicylic acid Sulphasalazine Sunitinib malate |
Epiphenomenon
Kasabach-Merritt syndrome Paraneoplastic syndrome