Thrombocytopenia: Difference between revisions
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*Mucosal bleeding (gingival, epistaxis) | *Mucosal bleeding (gingival, epistaxis) | ||
*Menorrhagia, hemoptysis, hematuria, hematochezia | *Menorrhagia, hemoptysis, hematuria, hematochezia | ||
*Deep tissue bleeding is less common | *Deep tissue/joint bleeding is less common (more likely due to coagulopathies) | ||
==Causes== | ==Causes== |
Revision as of 11:51, 26 April 2015
Background
- Spontaneous bleeding concerning when platelet count <20K
Clinical Features
- Nonpalpable petechiae/purpura
- Mucosal bleeding (gingival, epistaxis)
- Menorrhagia, hemoptysis, hematuria, hematochezia
- Deep tissue/joint bleeding is less common (more likely due to coagulopathies)
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
- Platelet loss
- Excessive hemorrhage
- Hemodialysis, extracorporeal circulation
- Splenic sequestration
- Sickle cell disease, cirrhosis
Diagnosis
- Platelet count (CBC)
Treatment
Platelet Transfusion Indications
- <50K & severe bleed or invasive procedure
- <20K & fever, petechia, or infection
- <10K
Transfusion contraindications
- TTP, DIC, HIT
Pediatrics
- 1 unit of platelets per 5kg body weight raises count by 50k
See Also
Source
Tintinalli