Avaliação da trombocitopenia
Resumo
Diagnósticos diferenciais
comuns
- Leucemia
- Neoplasia metastática
- Linfoma de Hodgkin
- Linfoma não Hodgkin
- Tuberculose miliar
- Coagulação intravascular disseminada (CIVD)
- Pós-transfusão
- Hemólise, enzimas hepáticas elevadas, plaquetopenia (HELLP)
- Derivação cardiopulmonar
- Trombocitopenia imune (ITP)
- Lúpus eritematoso sistêmico (LES)
- Artrite reumatoide
- Síndrome antifosfolipídica
- Vírus da imunodeficiência humana (HIV)/síndrome de imunodeficiência adquirida (AIDS)
- Malária
- Febre da dengue
- Infecção pelo vírus da Zika
- Citomegalovírus (CMV)
- Mononucleose infecciosa
- COVID-19
- Parvovírus B19
- Sepse
- Trombocitopenia induzida por heparina (TIH)
- Medicamentos antimaláricos, antiepilépticos, antibióticos ou quimioterápicos
- Ingestão de bebidas alcoólicas
- Deficiência de B12
- Deficiência de folato
- Trombocitopenia gestacional
- Cirrose
Incomuns
- Mieloma múltiplo
- Fibrose da medula óssea
- Púrpura trombocitopênica trombótica (PTT)
- Síndrome hemolítico-urêmica (SHU)
- Sarcoidose
- Trombocitopenia cíclica
- Síndrome de Wiskott-Aldrich
- Distúrbios relacionados a MYH9, incluindo anomalia de May-Hegglin
- Síndrome de Bernard-Soulier
- Doença de Gaucher
- Tireoidite de Hashimoto
- Anemia aplásica
- Vacinações
- Hemoglobinúria paroxística noturna (HPN)
- Pseudotrombocitopenia
- Distúrbio plaquetário hereditário com mutação em RUNX1 na linha germinativa.
- Trombocitopenia por mutação da linha germinativa em ANKRD26
- Trombocitopenia devido a mutação germinativa em ETV6
Colaboradores
Autores
Hanny Al-Samkari, MD
Division of Hematology/Oncology
Peggy S. Blitz Endowed Chair in Hematology/Oncology
Massachusetts General Hospital
Associate Professor of Medicine
Harvard Medical School
Boston
MA
Declarações
HA has received fees for consulting from Agios, Amgen, argenx, Alpine, Alnylam, Sobi, Pharmacosmos, Novartis and Sanofi; and received research funding to their institution from Amgen, Agios, Sobi, Novartis, and Vaderis.
Agradecimentos
Dr Hanny Al-Samkari would like to gratefully acknowledge Dr Julia T. Geyer and Dr Alan E. Lichtin, previous contributors to this topic. JTG declares that she has no competing interests. AEL is on an advisory board and has received research support from Amgen.
Revisores
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
Declarações
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Provan D, Arnold DM, Bussel JB, et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenia. Blood Adv. 2019 Nov 26;3(22):3780-817.Full text Abstract
Cines DB, Levine LD. Thrombocytopenia in pregnancy. Blood. 2017 Nov 23;130(21):2271-7.Full text Abstract
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 207: thrombocytopenia in pregnancy. Obstet Gynecol. 2019 Mar;133(3):e181-93. Abstract
Cooper N, Ghanima W. Immune thrombocytopenia. N Engl J Med. 2019 Sep 5;381(10):945-55.Full text Abstract
Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-143.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.
Guidelines
- A British Society for Haematology Guideline: diagnosis and management of thrombotic thrombocytopenic purpura and thrombotic microangiopathies
- Practice bulletin no. 207: thrombocytopenia in pregnancy
More GuidelinesPatient information
Linfoma não Hodgkin
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