Thrombocytopenia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Farbod Zahedi Tajrishi, M.D.

Overview

Thrombocytopenia has a broad range of potential causes. While a good history and physical examination can be helpful to diagnose some of these causes such as drug-induced thrombocytopenia, they usually don't suffice and further evaluation is often needed. There are also some useful points that may guide the physician to an appropriate diagnosis. For example, asymptomatic, isolated thrombocytopenia most probably suggests ITP, while thrombocytopenia in critically ill, hospitalized patients is usually suggestive of iatrogenic causes (eg. dilution), platelet consumption, bone marrow suppression from infection/sepsis, or even drug-induced thrombocytopenia. One should consider however, that a wide variety of other conditions such as autoimmune disorders, nutrient deficiencies, thrombotic microangiopathies could all as well cause thrombocytopenia.

Differential Diagnosis

Category Disease History and symptoms Laboratory findings Pathology
Cardiovascular endocarditis
pulmonary embolism
Chemical/poisoning Strontium-89
zinc
Dermatologic Cholesterol embolism
Elejalde syndrome
Griscelli syndrome type 1
neuroectodermal melanolysosomal disease
Hematologic Acquired pure megakaryocytic aplasia
aplastic anemia
Bernard-Soulier syndrome
congenital amegakaryocytic thrombocytopenia (CAMT)
disseminated intravascular coagulation
Epstein's syndrome
familial histiocytic reticulosis
Gasser syndrome
GATA1-related cytopenia
Glanzmann's thrombasthenia
grey platelet syndrome
hemolytic uremic syndrome
histiocytosis X
hypersplenism
idiopathic thrombocytopenic purpura
Jacobsen syndrome
Kasabach-Merritt syndrome
May-Hegglin anomaly
Moschcowitz syndrome
myelodysplastic syndrome
myelofibrosis
neonatal alloimmune thrombocytopenia
pancytopenia
Paris-Trousseau thrombocytopenia
paroxysmal nocturnal hemoglobinuria
post-transfusion purpura
radial aplasia-thrombocytopenia syndrome
Sebastian platelet syndrome
Shwachman-Diamond syndrome
thrombotic thrombocytopenic purpura
Von Willebrand disease
Werlhof disease
Wiskott-Aldrich syndrome

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