Thrombocytopenia history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Farbod Zahedi Tajrishi, M.D. [2]

History

A thorough history is essential to an effective evaluation of thrombocytopenia. While some of the conditions leading to thrombocytopenia can be immediately diagnosed, others may require specific or repeated questioning. In addition to a well-investigated present illness, a precise past medical history can help a great deal to identify the cause of thrombocytopenia. The history should include questions about:

• Bleeding (eg, petechiae, ecchymoses, epistaxis, gingival bleeding, hematemesis, melena, menorrhagia)
• Other symptpms such as fever, rashes, pain (eg, in bone), headache, or vision changes
• Recent travel (dengue fever, malaria, rickettsial infections, tick bite, leptospirosis, meningococcemia, Hantavirus, Ebola, Lassa fever
• Recent hospitalizations/ immunizations
• Any previous illnesses (esp. hematologic and rheumatologic) and recent infections, malignancies (eg, myelodysplastic syndrome, leukemia, lymphoma, aplastic anemia)
• Pregnancy
• Transfusions
• Organ transplant
• Medications (aspirin, NSAIDs, heparin, LMWH, etc.)/ herbs/ chemicals/ radiation
• Family history of bleeding disorders and/or thrombocytopenia. (Note: Negative family history does not rule out the possibility of genetic etiologies because some individuals with familial platelet disorders remain undiagnosed well into adulthood.)
• Dietary habits (eg, vegetarianism)
• High-risk behaviors (HIV, hepatitis)
• Alcohol/ drug use