Approach to Thrombocytopenia

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Workup• CBC• Absolute platelet count• Assess severity of thrombocytopenia• Mean platelet volume• High suggests destructive process or congenitalmacrothrombocytopenia• Low suggests Wiskott-Aldrich syndrome• Hemoglobin• Concurrent anemia suggests autoimmunehemolytic anemia, leukemia, or infiltration• Leukocyte counts and differential• Leukopenia suggests leukemia, infiltration
Workup• Peripheral Blood Smear• Confirm platelet count• Improper collection results in clumping andspurious thrombocytopenia• Red cell morphology• Spherocytes suggest autoimmune hemolyticanemia (coupled with immune thrombocytopeniadefines Evans syndrome)• Schistocytes suggest microangiopathic destruction(as in HUS, DIC, and TTP)
Page 1 and 2: The McMasterat nightPediatricCurric
Page 3 and 4: Background• Platelets are irregul
Page 5 and 6: The Answer• The normal platelet c
Page 7 and 8: The Case
Page 9 and 10: History• Past and current bleedin
Page 11 and 12: Physical ExamWhat would you look fo
Page 13: WorkupWhat would you order?
Page 17 and 18: Workup• A bone marrow exam is not
Page 19 and 20: Differential DiagnosisDecreased Pro
Page 21 and 22: ITP• Treatment is considered if p
Page 23 and 24: Neonatal AlloimmuneThrombocytopenia
Page 25 and 26: Kasabach-Merritt• Infant thromboc
Page 27 and 28: The Answer• Wiskott-Aldrich syndr
Page 29 and 30: The Answer• Persistent ITP can be
Page 31: Summary• There is no absolute thr

Approach to Thrombocytopenia

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