Differential diagnosis and treatment of thrombocytopenia.

Summary

Thrombocytopenia is usually acquired. The laboratory artefact of pseudothrombocytopenia should always be excluded. Bone marrow insufficiency with impaired platelet production results from infiltrating tumor cells or from a myelodsplastic syndrome. In patients with splenomegaly, platelets are trapped by the spleen. An increased platelet turnover is caused by activation of the clotting cascade, e.g. due to sepsis or malignancy. Platelet binding antibodies cause thrombocytopenia by increased platelet clearance. Important differential diagnoses in patients with severe thrombocytopenia are: acute leukemia, thrombotic thrombocytopenic purpura, autoimmune thrombocytopenia and drug-dependent thrombocytopenia. Multifactorial causes are thrombocytopenia associated with pregnancy, chronic alcohol abuse, and liver cirrhosis. Treatment should focus on the underlying disease. In regard to low platelet counts only clinical bleeding and not platelet count numbers should be treated.

Affiliation

Abteilung Transfusionsmedizin, UniversitÃ¤t Rostock, Rostock, Deutschland.

Journal Details

Name: Der Internist
ISSN: 1432-1289
Pages:

MESH Definitions

Diagnosis, Differential

Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures.

Calorimetry, Differential Scanning

Differential thermal analysis in which the sample compartment of the apparatus is a differential calorimeter, allowing an exact measure of the heat of transition independent of the specific heat, thermal conductivity, and other variables of the sample.

Early Diagnosis

Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.

Dna Nucleotidylexotransferase

A non-template-directed DNA polymerase normally found in vertebrate thymus and bone marrow. It catalyzes the elongation of oligo- or polydeoxynucleotide chains and is widely used as a tool in the differential diagnosis of acute leukemias in man. EC 2.7.7.31.

Carbazilquinone

An alkylating agent structurally similar to MITOMYCIN and found to be effective in the treatment of leukemia and various other neoplasms in mice. It causes leukemia and thrombocytopenia in almost all human patients.

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