Summary
Definition
History and exam
Key diagnostic factors
- bleeding
- absence of systemic symptoms
- absence of medications that cause thrombocytopenia
- absent splenomegaly or hepatomegaly
- absent lymphadenopathy
Risk factors
- women of childbearing age
- age <10 or >65 years
Diagnostic investigations
1st investigations to order
- CBC and peripheral blood smear
Investigations to consider
- HIV serology
- Helicobacter pylori breath test or stool antigen test
- hepatitis C serology
- thyroid function tests
- quantitative immune globulins
- bone marrow biopsy/aspiration
- pregnancy test
Treatment algorithm
all patients (child or adult): with life- or organ-threatening bleeding
newly diagnosed child
newly diagnosed adult (pregnant or nonpregnant):
child: persistent or chronic disease
adult nonpregnant: persistent or chronic disease
pregnant: persistent or chronic disease
Contributors
Authors
Marie Scully, MD, MRCP, FRCPath
Consultant Haematologist
University College London Hospitals
London
UK
Disclosures
MS has received honoraria from Novartis. MS is the author of a paper cited in this topic.
Acknowledgements
Dr Marie Scully would like to gratefully acknowledge Professor Francesco Rodeghiero and Dr Marco Ruggeri, previous contributors to this topic.
Disclosures
FR received fees for speaking and has been reimbursed by GSK and Amgen, the manufacturer of eltrombopag and romiplostim, for attending several conferences, and also received fees for consulting from GSK and Shionogi. FR and MR are authors of a number of references cited in this topic.
Peer reviewers
Keith McCrae, MD
Professor
Director of Benign Hematology
Cleveland Clinic
Cleveland
OH
Disclosures
KM declares that he has no competing interests.
Sandeep Kumar Rajan, MD
Assistant Professor
Division of Oncology-Hematology
Department of Internal Medicine
University of Nebraska Medical Center
Omaha
NE
Disclosures
SKR declares that he has no competing interests.
Differentials
- Pseudothrombocytopenia
- Congenital thrombocytopenia
- Acquired thrombocytopenia (e.g., related to liver disease or alcohol ingestion)
More DifferentialsGuidelines
- 2011 evidence-based practice guideline for immune thrombocytopenia
- 2011 evidence-based practice guideline for immune thrombocytopenia
More GuidelinesVideos
Venepuncture and phlebotomy: animated demonstration
Peripheral venous cannulation: animated demonstration
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