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Thrombocytopenia Differential Diagnosis
Differentiating the diseases that can cause thrombocytopenia:
Category | Condition | Mechanism | Clinical manifestations | Para−clinical findings | Gold standard | Associated findings | |||||||||
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Symptoms | Signs | ||||||||||||||
Lab Findings | Imaging | ||||||||||||||
Severity | Fever | Bleeding | BP | Other | CBC | PBS | Coagulopathy | ||||||||
Infectious diseases | 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 | |||||||||||||||
Infection | Viral infections | rubella, mumps, varicella, parvovirus, hepatitis C, and Epstein-Barr virus | |||||||||||||
HIV |
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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 |
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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 |