Thrombocytopenia Differential Diagnosis

Thrombocytopenia Differential Diagnosis:

Thrombocytopenia Differential Diagnosis - www

Thrombocytopenia is the medical term for a low blood platelet count. Platelets (thrombocytes) play an important role in blood clotting. Platelets stop blood loss by clumping and forming plugs in blood vessel holes. Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system problem, or even due to some medication side effect. It may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding can occur.


We can divide Thrombocytopenia into two different group of disorders based on their etiology:

1. Bone marrow disorders:

In this group of disorders, thrombocytopenia due to the bone marrow itself and it is not associated with any secondary cause or any other disorders. The main bone marrow disorders are:

  • Aplastic anemia
  • Hematologic malignancies (e.g. Leukemias)
  • Myelodysplasia
  • Megaloblastic anemia (Folic acid and B12 deficiency)
  • Alcoholism (causes vitamin deficiency such as folic acid and B12 deficiency)


2. Non-Bone marrow disorders:

In this group of disorders, thrombocytopenia is due to a secondary cause that eliminate platelets from circulation or may have  an effect on the bone marrow causing it to slow down or stop its production of platelets or .  Some of the secondary causes are:

  • Idiopathic thrombocytopenia purpura
  • Heparin induced thrombocytopenia
  • Hypersplenism
  • Disseminated intravascular coagulation (DIC)
  • Sepsis
  • Viral infection
  • HIV
  • Systemic lupus erythematosus (SLE)
  • Thrombotic thrombocytopenic purpura (TTP)
  • hemolytic uremic syndrome


General symptoms include:

  • Bleeding in the mouth and gums
  • Bruising
  • Nosebleeds
  • Rash (pinpoint red spots called petechia)


 Diagnostic test and Exams:

Your health care provider will perform a physical exam and ask questions about your medical history and symptoms. The following tests may be done:

  • Complete blood count (CBC)
  • Blood clotting studies (PTT and PT)

Other tests that may help diagnose this condition include:

  • Bone marrow aspiration or biopsy
  • Platelet associated antibodies



Thrombocytopenia usually improves when the underlying cause is treated. Sometimes medications, surgery or a blood transfusion can help treat chronic thrombocytopenia.


References: 1, 2


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