Thrombocytopenia (platelet count smaller than 150 x109/l) may be associated with a variety of conditions, with associated risks that range from life-threatening to none.
Abnormal bleeding associated with thrombocytopenia is characterized by spontaneous skin purpura and mucosal haemorrhage and prolonged bleeding after trauma. In asymptomatic patients with thrombocytopenia, common diagnoses include immune thrombocytopenia, drug-induced thrombocytopenia, occult liver disease, HIV infection and myelodysplastic syndromes. Congenital thrombocytopenias (sometimes misdiagnosed as immune thrombocytopenia) may also occur. Thrombocytopenia is confirmed by repeating the complete blood count and reviewing the peripheral blood smear. Hematologist consultation is appropriate if the cause of thrombocytopenia is unclear. Bone marrow evaluation is not required in all patients with thrombocytopenia; however, it may be helpful in some patients if the cause of thrombocytopenia is unclear, or if a primary hematologic disorder is suspected. Management of patients with thrombocytopenia depends on the underlying diagnosis.