Thrombocytopenia

In

Thrombocytopenia usually

Thrombocytopenia can be inherited or acquired.[12]

Decreased production

Abnormally low platelet production may be caused by:^[13]

• Dehydration, vitamin B₁₂ or folic acid deficiency
• Leukemia, myelodysplastic syndrome, or aplastic anemia
• Decreased production of thrombopoietin by the liver in liver failure
• bacterial infection
• Leptospirosis
• Hereditary syndromes^[14]
  • ACTN1-related thrombocytopenia
  • Amegakaryocytic thrombocytopenia with radio-ulnar synostosis
  • ANKRD26 related thrombocytopenia
  • Autosomal dominant thrombocytopenia
  • Bernard–Soulier syndrome (associated with giant platelet disorder)
  • Congenital amegakaryocytic thrombocytopenia
  • Congenital amegakaryocytic thrombocytopenia and radioulnar synostosis
  • CYCS-related thrombocytopenia
  • Epstein syndrome (associated with giant platelet disorder)
  • ETV6 related thrombocytopenia
  • Fanconi anemia
  • Filaminopathies A
  • FYB related thrombocytopenia
  • Glanzmann's thrombasthenia
  • GNE myopathy with congenital thrombocytopenia
  • Gray platelet syndrome (associated with giant platelet disorder)
  • Harris platelet syndrome (associated with giant platelet disorder)
  • Macrothrombocytopenia and hearing loss
  • May–Hegglin anomaly (associated with giant platelet disorder)
  • MYH9-related disease (associated with giant platelet disorder)
  • PRKACG-related thrombocytopenia
  • Paris-Trousseau thrombocytopenia/Jacobsen syndrome
  • Sebastian syndrome
  • SLFN14-related thrombocytopenia
  • Stormorken syndrome
  • TRPM7-related thrombocytopenia
  • Thrombocytopenia absent radius
    syndrome
  • Tropomyosin 4-related thrombocytopenia
  • TUBB1-related thrombocytopenia
  • Upshaw–Schulman syndrome
  • Wiskott–Aldrich syndrome
  • X-linked thrombocytopenia
  • X-linked thrombocytopenia with thalassemia

Increased destruction

Abnormally high rates of platelet destruction may be due to immune or nonimmune conditions, including:^[15]

• Immune thrombocytopenic purpura
• Thrombotic thrombocytopenic purpura
• Hemolytic–uremic syndrome
• Disseminated intravascular coagulation
• Paroxysmal nocturnal hemoglobinuria
• Antiphospholipid syndrome
• Systemic lupus erythematosus
• Post-transfusion purpura
• Neonatal alloimmune thrombocytopenia
• Hypersplenism
• Dengue fever
• Gaucher's disease
• Zika virus

Medication-induced

These medications can induce thrombocytopenia through direct myelosuppression:^[16]

• Valproic acid
• Methotrexate
• Carboplatin
• Interferon
• Isotretinoin
• Panobinostat
• H₂ blockers and proton-pump inhibitors

• Laboratory error, possibly due to the anticoagulant EDTA in CBC specimen tubes; a citrated platelet count is a useful follow-up study^{[17][additional citation(s) needed]}
• Snakebite^[18]
• Lyme disease^[19]
• Thrombocytapheresis (also called plateletpheresis)^{[citation needed]}
• Niemann–Pick disease^[20][21]

Diagnosis

Laboratory tests for thrombocytopenia might include

Thrombocytopenia in hospitalized alcoholics may be caused by spleen enlargement, folate deficiency, and most frequently, the direct toxic effect of alcohol on production, survival time, and function of platelets.^[23] Platelet count begins to rise after 2 to 5 days' abstinence from alcohol. The condition is generally benign, and clinically significant hemorrhage is rare.^{[citation needed]}

In severe thrombocytopenia, a bone marrow study can determine the number, size, and maturity of the megakaryocytes. This information may identify ineffective platelet production as the cause of thrombocytopenia and rule out a malignant disease process at the same time.^[24]

Treatment

Treatment is guided by the severity and specific cause of the disease. Treatment focuses on eliminating the underlying problem, whether that means discontinuing drugs suspected to cause it or treating underlying sepsis. Diagnosis and treatment of serious thrombocytopenia is usually directed by a

Platelet transfusions may be suggested for people who have a low platelet count due to thrombocytopenia.^[26]

Thrombotic thrombocytopenic purpura

Treatment of

Many cases of

Discontinuation of heparin is critical in a case of heparin-induced thrombocytopenia (HIT). Beyond that, however, clinicians generally treat to avoid thrombosis.

Bone marrow/stem cell transplants are the only known cures for this genetic disease. Frequent platelet transfusions are required to keep the patient from bleeding to death before the transplant can be performed, although this is not always the case.[34]

Human-induced pluripotent stem cell-derived platelets

Human-induced pluripotent stem cell-derived platelets is a technology currently being researched by the private sector, in association with the Biomedical Advanced Research and Development Authority and the U.S. Department of Health and Human Services, that would create platelets outside the human body.^[35]

Neonatal thrombocytopenia

Thrombocytopenia affects a few newborns, and its prevalence in neonatal intensive care units is high. Normally, it is mild and resolves without consequences. Most cases affect preterm birth infants and result from placental insufficiency and/or fetal hypoxia. Other causes, such as alloimmunity, genetics, autoimmunity, and infection, are less frequent.^[36]

Thrombocytopenia that starts after the first 72 hours, since birth is often the result of underlying

External links

Scholia has a topic profile for Thrombocytopenia.