Thrombocytopenia: Difference between revisions

Revision as of 00:31, 26 April 2015

Background

Spontaneous bleeding concerning when plt count <20K

Clinical Features

Nonpalpable petechiae/purpura
Mucosal bleeding (gingival, epistaxis)
Menorrhagia, hemoptysis, hematuria, hematochezia
Deep tissue bleeding is less common

Causes

Decreased production
- Marrow infiltration (tumor or infection)
- Viral infections (rubella, HIV)
- Drugs
  - Heparin Induced Thrombocytopenia
  - sulfa abx, ETOH, ASA, thiazides/furosemide
- Radiation
- Vitamin B12 and/or folate deficiency
Increased platelet destruction
- ITP
- TTP
- HUS
- DIC
- Viral infections (HIV, mumps, varicella, EBV)
- Drugs (heparin, protamine)
Platelet loss
- Excessive hemorrhage
- Hemodialysis, extracorporeal circulation
Splenic sequestration
- Sickle cell disease, cirrhosis

Treatment

Platelet Transfusion Indications

<50K & severe bleed or invasive procedure
<20K & fever, petechia, or infection
<10K

Transfusion contraindications

TTP, DIC, HIT

=Pediatrics

1u plt per 5kg body weight raises count by 50k

Source

Tintinalli

Authors:

@@ Line 9: / Line 9: @@
 ==Causes==
-#Decreased production
+*Decreased production
-##Marrow infiltration (tumor or infection)
+**Marrow infiltration (tumor or infection)
-##Viral infections (rubella, HIV)
+**Viral infections (rubella, HIV)
-##Drugs
+**Drugs
-###[[Heparin Induced Thrombocytopenia]]
+***[[Heparin Induced Thrombocytopenia]]
-###sulfa abx, ETOH, ASA, thiazides/furosemide
+***sulfa abx, ETOH, ASA, thiazides/furosemide
-##Radiation
+**Radiation
-##Vitamin B12 and/or folate deficiency
+**Vitamin B12 and/or folate deficiency
-#Increased platelet destruction
+*Increased platelet destruction
-##[[ITP]]
+**[[ITP]]
-##[[TTP]]
+**[[TTP]]
-##[[HUS]]
+**[[HUS]]
-##[[DIC]]
+**[[DIC]]
-##Viral infections (HIV, mumps, varicella, EBV)
+**Viral infections (HIV, mumps, varicella, EBV)
-##Drugs (heparin, protamine)
+**Drugs (heparin, protamine)
-#Platelet loss
+*Platelet loss
-##Excessive hemorrhage
+**Excessive hemorrhage
-##Hemodialysis, extracorporeal circulation
+**Hemodialysis, extracorporeal circulation
-#Splenic sequestration
+*Splenic sequestration
-##Sickle cell disease, cirrhosis
+**Sickle cell disease, cirrhosis
 ==Treatment==
-#[[Platelet Transfusion]] Indications:
+===[[Platelet Transfusion]] Indications===
-##<50K & severe bleed or invasive procedure
+*<50K & severe bleed or invasive procedure
-##<20K & fever, petechia, or infection
+*<20K & fever, petechia, or infection
-##<10K
+*<10K
-#Transfusion contraindications:
-##TTP, DIC, HIT
+===Transfusion contraindications===
-#Peds
+*TTP, DIC, HIT
-##1u plt per 5kg body weight raises count by 50k
+===Pediatrics==
+*1u plt per 5kg body weight raises count by 50k
 ==See Also==