Thrombocytopenia causes
|
Thrombocytopenia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Thrombocytopenia causes On the Web |
|
American Roentgen Ray Society Images of Thrombocytopenia causes |
|
Risk calculators and risk factors for Thrombocytopenia causes |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
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
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Abruptio placentae[1]
- Bone marrow suppression (chemotherapy, irradiation)
- Cardica bypass[1]
- Chronic alcohol use
- Chronic liver disease[2]
- Common variable immunodeficiency[1]
- Congenital thrombocytopenia
- Connective tissue disorders (eg SLE, RA, antiphospholipid syndrome)[1]
- Disseminated intravascular coagulation[2]
- GP IIb/IIIa inhibitor[1]
- Hemolytic uremic syndrome
- Heparin-induced thrombocytopenia
- Immune thrombocytopenic purpura[3]
- Infections[2]
- Macrophage-activation syndrome[1]
- Medications[2]
- Preeclampsia
- Pregnancy[4]
- Pseudothrombocytopenia
- Thrombotic thrombocytopenic purpura[5]
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 [3]
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:
|
Sulphonamides Drugs, hormones and mediators Aclarubicin Anazolene Antithymocyte globulin Arsenic trioxide
|
Guanidinium Haem arginate Methyldopate
|
Para-amino salicylic acid Sulphasalazine Sunitinib malate |
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Stasi R (2012). "How to approach thrombocytopenia". Hematology Am Soc Hematol Educ Program. 2012: 191–7. doi:10.1182/asheducation-2012.1.191. PMID 23233580.
- ↑ 2.0 2.1 2.2 2.3 Greenberg EM, Kaled ES (2013). "Thrombocytopenia". Crit Care Nurs Clin North Am. 25 (4): 427–34, v. doi:10.1016/j.ccell.2013.08.003. PMID 24267279.
- ↑ Farid J, Gul N, Qureshi WU, Idris M (2012). "Clinical presentations in immune thrombocytopenic purpura". J Ayub Med Coll Abbottabad. 24 (2): 39–40. PMID 24397048.
- ↑ Nisha S, Amita D, Uma S, Tripathi AK, Pushplata S (2012). "Prevalence and characterization of thrombocytopenia in pregnancy in Indian women". Indian J Hematol Blood Transfus. 28 (2): 77–81. doi:10.1007/s12288-011-0107-x. PMC 3332269. PMID 23730013.
- ↑ Abdel Karim N, Haider S, Siegrist C, Ahmad N, Zarzour A, Ying J; et al. (2013). "Approach to management of thrombotic thrombocytopenic purpura at university of cincinnati". Adv Hematol. 2013: 195746. doi:10.1155/2013/195746. PMC 3876823. PMID 24396345.