How I approach new onset thrombocytopenia.

Platelets

Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia.

Published: September 2020

AI Article Synopsis

  • Thrombocytopenia often leads patients to seek referrals to hematologists due to the potentially serious implications and the need for rapid evaluation and emergency care.
  • The review discusses the essential steps for initial assessment, diagnosis, and referral, emphasizing the importance of thorough clinical history, examination, and lab tests to narrow down the cause.
  • Immune Thrombocytopenic Purpura (ITP) is identified as the most common cause of severe isolated thrombocytopenia, but clinicians must remain vigilant for alternative diagnoses, especially with atypical presentations or unexpected treatment outcomes.

Article Abstract

Thrombocytopenia is a common reason for referral to hematologists in community and hospital practice. A broad differential diagnosis, combined with the potentially life-threatening nature of some presentations necessitates a rapid evaluation of the situation and potential need for emergency intervention; followed by further comprehensive investigation to confirm the diagnosis and institution of longer term management. This review offers an approach to the initial assessment, diagnosis, and referral. We then highlight aspects of the clinical history, examination and laboratory investigations which may provide critical insights into the most likely diagnosis. ITP is the commonest cause of severe isolated thrombocytopenia in the general community and is the most common cause of thrombocytopenia in patients referred to our hematology service. It remains a diagnosis of exclusion and a high degree of vigilance for alternative diagnoses should be maintained, particularly if presentations are atypical or expected response to treatment is not seen. Adult presentation of hereditary thrombocytopenia syndromes can mimic new onset thrombocytopenia, however, improving access to genetic testing will facilitate accurate diagnosis and avoid unnecessary treatment.

Download full-text PDF

Source
http://dx.doi.org/10.1080/09537104.2019.1637835DOI Listing

Publication Analysis

Top Keywords

onset thrombocytopenia
8
thrombocytopenia
6
diagnosis
6
approach onset
4
thrombocytopenia thrombocytopenia
4
thrombocytopenia common
4
common reason
4
reason referral
4
referral hematologists
4
hematologists community
4

Similar Publications

Anti-seizure medications (ASMs) are specific types of anticonvulsants used to treat epileptic seizures. However, several studies have shown an association between ASMs and an increased risk of hematological disorders, such as thrombocytopenia, aplastic anemia, and platelet function disorders leading to prolonged bleeding times. This review explores the existing literature on this topic, investigating a wide variety of ASMs, ranging from first-generation medications to newer ones.

View Article and Find Full Text PDF

Background Sepsis is a life-threatening condition characterized by multiple organ dysfunction. Blood cells abnormalities play a significant role in the onset and progression of sepsis; however, the potential causal relationship between platelets and sepsis remains unclear, as does whether immune cells mediate the interaction between platelets and sepsis. This study aims to explore the potential causal relationship between platelets and sepsis and analyze the mediating effect of immune cells.

View Article and Find Full Text PDF

Clinical implications of human Parvovirus B19 infection on autoimmunity and autoimmune diseases.

Int Immunopharmacol

January 2025

Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; Department of Clinical Laboratory, Chung Shan Medical University Hospital, Taichung 402, Taiwan; Immunology Research Center, Chung Shan Medical University, Taichung 402, Taiwan. Electronic address:

Parvovirus B19 (B19V) is a human pathogen from the Parvoviridae family that primarily targets and replicates in erythroid progenitor cells (EPCs). While its symptoms are typically self-limiting in healthy individuals, B19V can cause or exacerbate autoimmune diseases in vulnerable patients. This review integrates the involvement of B19V in the development and worsening of several autoimmune diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), hematological disorders (thalassemia, anemia, and thrombocytopenia), vasculitis, antiphospholipid syndrome (APS), dermatological disease (systemic sclerosis, psoriasis), autoimmune thyroid disease, myocarditis, and myasthenia gravis, and autoinflammatory disease of adult-onset Still's disease (AOSD).

View Article and Find Full Text PDF

[New Advances in the Study of VEXAS Syndrome --Review].

Zhongguo Shi Yan Xue Ye Xue Za Zhi

December 2024

Department of Hematology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, Jiangsu Province, China.

Article Synopsis
  • VEXAS syndrome is an adult-onset autoinflammatory disorder linked to somatic mutations in the X-linked gene affecting the ubiquitin system.
  • Patients exhibit a variety of symptoms, including fever, inflammation, and hematological issues like anemia and thrombocytopenia, leading to high morbidity and mortality.
  • Current treatments focus on managing symptoms and mutations but are not well-developed, emphasizing the need for supportive care and risk factor management.
View Article and Find Full Text PDF

It is unclear whether drugs other than warfarin can cause spontaneous gastrointestinal intraluminal hematomas (SGIH). This study aimed to investigate the drugs that induced SGIH based on the FDA Adverse Event Reporting System (FAERS) data. A retrospective pharmacovigilance study was conducted.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!