Washington Manual of Medical Therapeutics
Thrombocytopenia
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Thrombocytopenia, defined as a platelet count of <150 × 109/L (reference range varies depending on local laboratory standard), is caused by decreased production, increased destruction, or sequestration of platelets (Table 20-2).
| Decreased Platelet Production | Increased Platelet Clearance |
| Marrow failure syndromes Congenital Acquired: Aplastic anemia, paroxysmal nocturnal hemoglobinuria Hematologic malignancies Marrow infiltration: Cancer, granuloma Myelofibrosis: Primary or secondary Nutritional: Vitamin B12 and folate deficiencies Physical damage to the bone marrow: Radiation, alcohol, chemotherapy | Immune-mediated mechanisms Immune thrombocytopenic Thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome Posttransfusion purpura Heparin-induced thrombocytopenia Non–immune-mediated mechanisms DIC Local consumption (aortic aneurysm) Acute hemorrhage |
| Increased Splenic Sequestration | Infections Associated With Thrombocytopenia |
| Portal hypertension Felty syndrome Lysosomal storage disorders Infiltrative hematologic malignancies Extramedullary hematopoiesis | HIV, HHV-6, ehrlichia, rickettsia, malaria, hepatitis C, CMV, Epstein-Barr, Helicobacter pylori, Escherichia coli O157 |
CMV, cytomegalovirus; DIC, disseminated intravascular coagulation; HHV-6, human herpesvirus 6.
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Thrombocytopenia, defined as a platelet count of <150 × 109/L (reference range varies depending on local laboratory standard), is caused by decreased production, increased destruction, or sequestration of platelets (Table 20-2).
| Decreased Platelet Production | Increased Platelet Clearance |
| Marrow failure syndromes Congenital Acquired: Aplastic anemia, paroxysmal nocturnal hemoglobinuria Hematologic malignancies Marrow infiltration: Cancer, granuloma Myelofibrosis: Primary or secondary Nutritional: Vitamin B12 and folate deficiencies Physical damage to the bone marrow: Radiation, alcohol, chemotherapy | Immune-mediated mechanisms Immune thrombocytopenic Thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome Posttransfusion purpura Heparin-induced thrombocytopenia Non–immune-mediated mechanisms DIC Local consumption (aortic aneurysm) Acute hemorrhage |
| Increased Splenic Sequestration | Infections Associated With Thrombocytopenia |
| Portal hypertension Felty syndrome Lysosomal storage disorders Infiltrative hematologic malignancies Extramedullary hematopoiesis | HIV, HHV-6, ehrlichia, rickettsia, malaria, hepatitis C, CMV, Epstein-Barr, Helicobacter pylori, Escherichia coli O157 |
CMV, cytomegalovirus; DIC, disseminated intravascular coagulation; HHV-6, human herpesvirus 6.
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