Summary
Differentials
Common
- Purpura simplex
- Actinic purpura (also known as senile purpura)
- Medications
- Alcohol use disorder
- Drug-induced thrombocytopenia
- Platelet storage pool disease
- von Willebrand disease (vWD)
- Vitamin K deficiency
- Cirrhosis
- Vasculitis
Uncommon
- Hereditary hemorrhagic telangiectasia (HHT)
- Cushing syndrome
- Child abuse
- Elder abuse
- Immune thrombocytopenia (ITP)
- Thrombotic thrombocytopenic purpura (TTP)
- Hemolytic uremic syndrome (HUS)
- Disseminated intravascular coagulation
- Wiskott-Aldrich syndrome
- MYH9-related disorders
- Bernard-Soulier disease
- Thrombocytopenia with absent radius syndrome
- Glanzmann thrombasthenia
- Acute myelogenous leukemia
- Acute lymphocytic leukemia
- Hodgkin lymphoma
- Non-Hodgkin lymphoma
- Multiple myeloma
- Solid tumor with infiltration of bone marrow
- Myelofibrosis
- Myelodysplastic syndrome
- Aplastic anemia
- Hemophilia
- Factor V, VII, X, or XI deficiency
- Acquired coagulation inhibitors
- Vitamin C deficiency
- Marfan syndrome
- Ehlers-Danlos syndrome
- Acute liver failure
- Gardner-Diamond syndrome
Contributors
Authors
Tzu-Fei Wang, MD
Assistant Professor of Internal Medicine
The Ohio State University
Columbus
OH
Disclosures
TW declares that she has received an honorarium from Daiichi Sankyo.
Eric H. Kraut, MD
Professor of Internal Medicine
The Ohio State University
Columbus
OH
Disclosures
EHK declares that he has no competing interests.
Peer reviewers
Donald M. Arnold, MDCM, MSc
Associate Professor
Department of Medicine
McMaster University
Hamilton
Ontario
Canada
Disclosures
DMA has received speaking honoraria from Amgen for presentation on immune thrombocytopenia; consulting fees from Amgen, and Bristol-Myers Squibb for ITP related studies; and research grants from Amgen, GlaxoSmithKline, and Hoffman-La Roche for clinical studies in ITP. He is co-author of a reference cited in this topic.
Deborah Siegel, MD, MSc, FRCPC
Clinical Scholar
McMaster University
St. Joseph’s Healthcare Hamilton
Hamilton
Ontario
Canada
Disclosures
DS declares that she has no competing interests.
Riten Kumar, MD, MSc
Assistant Professor of Pediatrics
Nationwide Children’s Hospital
Ohio State University
Columbus
OH
Disclosures
RK declares that he has no competing interests.
David Keeling, BSc, MD, FRCP, FRCPath
Consultant Haematologist
Oxford Haemophilia & Thrombosis Centre
Churchill Hospital
Oxford
UK
Disclosures
DK declares that he has no competing interests.
Professor Cheng-Hock Toh, MBChB, MD, FRCP, FRCPath
Professor of Haematology
University of Liverpool
Liverpool
UK
Disclosures
CHT declares that he has no competing interests.
Shankaranarayana Paneesha, MBBS, MD, FRCP, FRCPath
Consultant Haematologist
Heart of England NHS Foundation Trust
Birmingham
UK
Disclosures
SP has received a speaker fee from Janssen.
References
Key articles
Faughnan ME, Mager JJ, Hetts SW, et al. Second international guidelines for the diagnosis and management of hereditary hemorrhagic telangiectasia. Ann Intern Med. 2020 Dec 15;173(12):989-1001.Full text Abstract
Tiede A, Collins P, Knoebl P, et al. International recommendations on the diagnosis and treatment of acquired hemophilia A. Haematologica. 2020 Jul;105(7):1791-801.Full text Abstract
Neunert C, Terrell DR, Arnold DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019 Dec 10;3(23):3829-66.Full text Abstract
Rodeghiero F, Tosetto A, Abshire T, et al. ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders. J Thromb Haemost. 2010;8:2063-2065.Full text Abstract
Platton S, Baker P, Bowyer A, et al. Guideline for laboratory diagnosis and monitoring of von Willebrand disease: a joint guideline from the United Kingdom Haemophilia Centre Doctors' Organisation and the British Society for Haematology. Br J Haematol. 2024 May;204(5):1714-31.Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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