Evaluation of thrombocytopenia

Last reviewed: 21 Nov 2024
Last updated: 25 Jun 2024

Summary

Differentials

Common

  • Leukemia
  • Metastatic malignancy
  • Hodgkin lymphoma
  • Non-Hodgkin lymphoma
  • Miliary tuberculosis
  • Disseminated intravascular coagulation (DIC)
  • Post-transfusion
  • Hemolysis, elevated liver enzymes, low platelet count (HELLP)
  • Cardiopulmonary bypass
  • Immune thrombocytopenia (ITP)
  • Systemic lupus erythematosus (SLE)
  • Rheumatoid arthritis
  • Antiphospholipid syndrome
  • HIV/AIDS
  • Malaria
  • Dengue fever
  • Zika virus infection
  • Cytomegalovirus (CMV)
  • Infectious mononucleosis
  • COVID-19
  • Parvovirus B19
  • Sepsis
  • Heparin-induced thrombocytopenia (HIT)
  • Antimalarials, antiseizure drugs, antibiotics, or chemotherapies
  • Alcohol ingestion
  • B12 deficiency
  • Folate deficiency
  • Gestational thrombocytopenia
  • Cirrhosis
Full details

Uncommon

  • Multiple myeloma
  • Bone marrow fibrosis
  • Thrombotic thrombocytopenic purpura (TTP)
  • Hemolytic uremic syndrome (HUS)
  • Sarcoidosis
  • Cyclic thrombocytopenia
  • Wiskott-Aldrich syndrome
  • MYH9-related disorders, including May-Hegglin anomaly
  • Bernard-Soulier syndrome
  • Gaucher disease
  • Hashimoto thyroiditis
  • Aplastic anemia
  • Vaccinations
  • Paroxysmal nocturnal hemoglobinuria (PNH)
  • Pseudothrombocytopenia
  • Familial platelet disorder with germline RUNX1 mutation
  • Thrombocytopenia due to germline ANKRD26 mutation
  • Thrombocytopenia due to germline ETV6 mutation
Full details

Contributors

Authors

Julia T. Geyer, MD

Associate Professor

Weill Cornell Medicine

Pathology and Laboratory Medicine

Division of Immunopathology

New York

NY

Disclosures

JTG declares that she has no competing interests.

Acknowledgements

Dr Julia T. Geyer would like to gratefully acknowledge Dr Alan E. Lichtin, a previous contributor to this topic.

Disclosures

AEL is on an advisory board and has received research support from Amgen.

Peer reviewers

Roger M. Lyons, MD, FACP

Clinical Professor of Medicine

University of Texas Health Science Center

San Antonio

Cancer Care Network of South Texas

San Antonio

TX

Disclosures

RML declares that he has no competing interests.

Jeffrey S. Wasser, MD

Clinical Assistant Professor of Medicine

University of Connecticut School of Medicine

Farmington

CT

Disclosures

JSW has received research support from Amgen, Ligand Pharmaceuticals, and MGI Pharma for clinical studies in immune thrombocytopenic purpura.

Keith R. McCrae, MD

Professor of Medicine

Case Western Reserve University School of Medicine

Cleveland

OH

Disclosures

KRM declares that he has no competing interests.

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