Thrombocytopenia differential diagnosis: Difference between revisions

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{{Thrombocytopenia}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Thrombocytopenia]]
{{CMG}}; '''Associate Editor-In-Chief:''' [[User:Farbod Zahedi Tajrishi|Farbod Zahedi Tajrishi, M.D.]]
{{CMG}}; {{AE}} {{SSH}}, [https://www.wikidoc.org/index.php/User:Farbod_Zahedi_Tajrishi <nowiki>Farbod Zahedi Tajrishi, M.D. [2]</nowiki>]


==Overview==
==Overview==
[[Thrombocytopenia]] has a broad range of potential causes. While a good [[History and Physical examination|history and physical examination]] can be helpful to diagnose some of these causes such as drug-induced thrombocytopenia, they usually don't suffice and further evaluation is often needed. There are also some useful points that may guide the [[physician]] to an appropriate [[diagnosis]]. For example, [[asymptomatic]], isolated [[thrombocytopenia]] most probably suggests [[Idiopathic thrombocytopenic purpura|ITP]], while [[thrombocytopenia]] in critically ill, hospitalized patients is usually suggestive of [[Iatrogenesis|iatrogenic]] causes (eg. [[dilution]]), [[platelet]] consumption, [[bone marrow suppression]] from [[infection]]/[[sepsis]], or even [[drug-induced thrombocytopenia]]. One should consider however, that a wide variety of other conditions such as [[autoimmune disorders]], [[nutrient]] deficiencies, [[thrombotic microangiopathies]] could all as well cause [[thrombocytopenia]].
[[Thrombocytopenia]] has a broad range of potential causes. While a good [[History and Physical examination|history and physical examination]] can be helpful to diagnose some of these causes such as drug-induced thrombocytopenia, they usually don't suffice and further evaluation is often needed. There are also some useful points that may guide the [[physician]] to an appropriate [[diagnosis]]. For example, [[asymptomatic]], isolated [[thrombocytopenia]] most probably suggests [[Idiopathic thrombocytopenic purpura|ITP]], while [[thrombocytopenia]] in critically ill, hospitalized patients is usually suggestive of [[Iatrogenesis|iatrogenic]] causes (eg. [[dilution]]), [[platelet]] consumption, [[bone marrow suppression]] from [[infection]]/[[sepsis]], or even drug-induced thrombocytopenia. One should consider however, that a wide variety of other conditions such as [[autoimmune disorders]], [[nutrient]] deficiencies, [[thrombotic microangiopathies]] could all as well cause [[thrombocytopenia]].


==Differential Diagnosis==
==Thrombocytopenia Differential Diagnosis==
{| class="wikitable"
'''Differentiating the diseases that can cause thrombocytopenia:'''
! rowspan="2" |Category
{|
!
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
! rowspan="2" |Disease
! colspan="2" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
! rowspan="2" |History and symptoms
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
! rowspan="2" |Physical exam
! colspan="3" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mechanism
! colspan="3" |Laboratory findings
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
! rowspan="2" |Pathology
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
! rowspan="2" |Other specifics
! colspan="9" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
! colspan="8" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para−clinical findings
! colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
|
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
|[[White blood cells|WBC]] changes
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
|[[Red blood cell|RBC/]][[hemoglobin]]<nowiki/>changes
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
|other findings
| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
|-
|-
| rowspan="2" |'''Cardiovascular'''
! colspan="8" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
|
|[[endocarditis]]<ref name="abc">Infective endocarditis. Wikipedia (2015). https://en.wikipedia.org/wiki/Infective_endocarditis Accessed on September 24, 2015</ref>
|
* [[Rigors]]
* [[Fever|Fevers]]
* [[Chills]]
* [[Anorexia]]
* [[Malaise]]
* [[Fatigue]]
* [[Weight loss]]
* [[Embolism|Embolic symptoms]]
|'''Skin'''
* [[Petechiae]]
* [[Splinter hemorrhages]]
* [[Osler's nodes]]
* [[Janeway lesion|Janeway lesions]]
Oral Cavity
* [[Periodontal diseases|Periodontal]] abnormalities
'''Eyes'''
* [[Conjunctival hemorrhage]]
* [[Roth's spot|Roth's spots]] in the [[retina]]
'''Ear Nose and Throat'''
* Bobbing of the [[uvula]] may be present among patients with new onset [[aortic regurgitation]].
'''Cardiovascular'''
* Heart [[Murmur|murmurs]]
* Wide [[pulse pressure]]
'''Lungs'''
* [[Rales]] as a result of [[heart failure]]
'''Abdomen'''
* [[Abdominal pain]] and [[reduced bowel sounds]] due to mesenteric embolization or [[ileus]]
* [[Splenomegaly]]
* [[Flank pain]] as a result of an [[embolus to the kidney]].
'''Neurologic'''
* [[Septic emboli]] may result in [[stroke]] and focal neurologic findings
* [[Seizures]]
* [[Intracranial hemorrhage]]
|    ↑
|<nowiki>-</nowiki>
|
* ↑ [[Erythrocyte sedimentation rate|ESR]]
* ↑ [[Rheumatoid factor|RF]], [[Blood urea nitrogen|BUN]] and [[Creatinine|Cr]] may also be present
|
'''Pathological Criteria'''
* Microorganisms demonstrated by culture or histological examination of a vegetation, a vegetation that has embolized, or an intracardiac abscess specimen
: OR
* Pathological lesions; vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis
|'''Diagnostic criteria:<ref name="Durack">{{cite journal | author = Durack D, Lukes A, Bright D | title = New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service. | journal = Am J Med | volume = 96 | issue = 3 | pages = 200-9 | year = 1994 | id = PMID 8154507}}</ref>'''
 
'''''Criteria for Rejecting the Diagnosis'''''
* Firm alternate diagnosis to infective endocarditis
* Resolution of infective endocarditis syndrome in under 4 days on antibiotics
* '''''Does not meet the criteria below:'''''
 
'''''Criteria for Definitive Endocarditis'''''
 
The Duke Clinical Criteria for definitive infective endocarditis require either:
* Two major criteria
: OR
* One major and three minor criteria
: OR
* Five minor criteria
 
=== Major Criteria ===
'''1. Positive Blood Culture for Infective Endocarditis'''
: '''A. Typical microorganism consistent with infective endocarditis from 2 separate blood cultures, as noted below:'''
:: ☑ [[Viridans streptococci]], ''[[Streptococcus bovis]]'', '''or'''
:: ☑ [[HACEK]] group, '''or'''
:: ☑ Community-acquired ''[[Staphylococcus aureus]]'' or [[enterococci]], in the absence of a primary focus
: OR
: '''B. Microorganisms consistent with infective endocarditis from persistently positive blood cultures defined as:'''
:: ☑ 2 positive cultures of blood samples drawn >12 hours apart, '''or'''
:: ☑ All of 3 or a majority of 4 separate cultures of blood (with first and last sample drawn 1 hour apart)
'''2. Evidence of endocardial involvement'''
: '''Positive echocardiogram for infective endocarditis defined as:'''
:: ☑ Oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, '''or'''
:: ☑ On implanted material in the absence of an alternative anatomic explanation, '''or'''
:: ☑ Abscess, '''or'''
:: ☑ New partial dehiscence of prosthetic valve
: OR
:: ☑ New valvular regurgitation (worsening or changing of preexisting murmur not sufficient)
'''Minor criteria:'''
: ☑ Predisposition: predisposing heart condition or [[intravenous drug use]]
: ☑ [[Fever]]: temperature > 38.0° C (100.4° F)
: ☑ Vascular phenomena: major arterial emboli, septic pulmonary infarcts, [[mycotic aneurysm]], [[intracranial hemorrhage]], [[Conjunctival hemorrhage|conjunctival hemorrhages]], and [[Janeway lesions]]
: ☑ Immunologic phenomena: [[glomerulonephritis]], [[Osler's nodes]], [[Roth spot|Roth spots]], and [[rheumatoid factor]]
: ☑ Microbiological evidence: positive [[blood culture]] but does not meet a major criterion as noted above (see footnote) or serological evidence of active infection with organism consistent with infectious endocarditis
: ☑ Echocardiographic findings: consistent with infectious endocarditis but do not meet a major criterion as noted above
: '''Footnote:''' It should be noted that the criteria exclude single positive cultures for [[coagulase-negative staphylococci]], diphtheroids, and organisms that do not commonly cause endocarditis.
|-
|-
|
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
|[[pulmonary embolism]]<ref name="pmid241826422">{{cite journal| author=Cohen AT, Dobromirski M, Gurwith MM| title=Managing pulmonary embolism from presentation to extended treatment. | journal=Thromb Res | year= 2014 | volume= 133 | issue= 2 | pages= 139-48 | pmid=24182642 | doi=10.1016/j.thromres.2013.09.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24182642  }}</ref>
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
|
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
* [[Dyspnea]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
* [[Pleuritic chest pain]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
* [[Fainting]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
* [[Cough]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
* [[Substernal chest pain]]
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |CBC
* [[Hemoptysis]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
* [[Wheezing]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
* [[Cyanosis]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
* [[Fever]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
|
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
|
|
|
* ↑ [[D-dimer]]
|
|
* positive findings on [[CT angiography|CT-angiogram]]
|-
|-
| rowspan="2" |'''Chemical/poisoning'''
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
|[[Strontium-89]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
|
|
|
|
|-
|-
|
! rowspan="17" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hematology
|[[zinc]]
! rowspan="4" align="center" style="background:#DCDCDC;" + |Bone marrow disorders
|
! align="center" style="background:#DCDCDC;" + |[[Myelodysplastic syndrome|Myelodysplastic syndromes]]<ref name="NatelsonPyatt2013">{{cite journal|last1=Natelson|first1=Ethan A.|last2=Pyatt|first2=David|title=Acquired Myelodysplasia or Myelodysplastic Syndrome: Clearing the Fog|journal=Advances in Hematology|volume=2013|year=2013|pages=1–11|issn=1687-9104|doi=10.1155/2013/309637}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* Unknown
|
* Mutation
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Elderly
| align="center" style="background:#F5F5F5;" + |Exposure to
* [[Chemotherapy]]
* [[Radiation therapy]]
* [[Tobacco smoking|Tobacco smoke]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |[[Petechia|Petechiae]], [[purpura]], diffuse erythematous rash
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Shortness of breath]]
* [[Fatigue]]
* [[Pallor]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* Ovalomacrocytosis
* Basophilic stippling
* [[Howell-Jolly body]]
* Dysplastic [[Neutrophil|neutrophils]]
| align="center" style="background:#F5F5F5;" + |
* Impaired [[myeloid]] maturation
* [[Congenital dyserythropoietic anemia|Dyserythropoiesis]]
* Dysgranulopoiesis
* Dysmegakaryocytopoiesis
* Hypercellular [[bone marrow]]
* [[Fibrosis]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |[[Bone marrow examination]] + clinical manifestation
| align="center" style="background:#F5F5F5;" + |
* Might transformed to [[acute leukemia]]
|-
|-
| rowspan="2" |'''Dermatologic'''
! align="center" style="background:#DCDCDC;" + |[[Aplastic anemia]]<ref name="TownsleyDesmond2013">{{cite journal|last1=Townsley|first1=Danielle M.|last2=Desmond|first2=Ronan|last3=Dunbar|first3=Cynthia E.|last4=Young|first4=Neal S.|title=Pathophysiology and management of thrombocytopenia in bone marrow failure: possible clinical applications of TPO receptor agonists in aplastic anemia and myelodysplastic syndromes|journal=International Journal of Hematology|volume=98|issue=1|year=2013|pages=48–55|issn=0925-5710|doi=10.1007/s12185-013-1352-6}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|[[Cholesterol embolism]]
* Unknown
|'''General:'''
* secondary to [[Radiation (medicine)|radiation]], drugs and chemicals, [[pregnancy]], [[Paroxysmal nocturnal hemoglobinuria|PNH]] and viral or [[Autoimmune disease|autoimmune]] causes
* [[fever]],
 
* [[myalgia]]
| align="center" style="background:#F5F5F5;" + | +
* [[Weight loss#Unintentional weight loss|weight loss]]
| align="center" style="background:#F5F5F5;" + | −
'''Organ-dependent:'''
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + |Biphasic (the young and the elderly)
| align="center" style="background:#F5F5F5;" + |
* Exposure to chemicals
* [[Radiation therapy|Radiation]]
* History of prior drug use
* [[Viral infections|Viral infection]]
* Positive family history of aplastic anemia
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Shortness of breath]]
* [[Fatigue]]
* [[Pallor]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* Large [[Red blood cell|RBCs]]
* Low [[Platelet|platelets]] and [[Granulocyte|granulocytes]]
 
| align="center" style="background:#F5F5F5;" + |
* Hypocellular [[bone marrow]]
* replacement of [[bone marrow]] by [[fat]]
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |[[Bone marrow examination]] +


Lower extremities
laboratory findings
* [[Livedoid vasculitis|livedo reticularis]]
| align="center" style="background:#F5F5F5;" + |
Kidney
* [[Fanconi anemia|Fanconi Anemia]]
* symptoms of [[Renal insufficiency|renal failure]] or [[nephrotic syndrome]]
* [[Dyskeratosis congenita]]
Gastroinstestinal
* [[Shwachman-Diamond syndrome|Schwachman-Diamond syndrome]]
* reduced appetite
* [[Preleukemia]]
* nausea and vomiting
* nonspecific [[abdominal pain]]
* [[gastrointestinal hemorrhage]] 
Central nervous system
* [[stroke]]-like symptoms
* [[headache]]
* [[amaurosis fugax]]
* [[paraparesis]]
* [[cauda equina syndrome]]
* loss of control over the [[bladder]], [[rectum]] and skin sensation around the anus
* [[mononeuropathy]].
|
| ↑/-
|↓/-
|
:* ↑ [[Blood urea nitrogen|BUN]] and [[Creatinine|Cr]] in case of renal failure
:* [[Creatine kinase|CPK]] and [[troponin]] in case of myocardial infarction
:* [[Occult blood|OB]]+ in case of mesenteric ischemia
:* Peripheral [[eosinophilia]]
:* Urinary [[eosinophilia]] in patients with cholesterol-renal disease
:* [[Complement deficiency|Hypocomplementemia]]
:* ↑ [[Erythrocyte sedimentation rate|ESR]]
|<nowiki>-</nowiki>
|
|-
|
|[[Griscelli syndrome|Griscelli syndrome]]
|
* characteristic [[hypopigmentation]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|
|
|-
|-
| rowspan="5" |'''Ear Nose Throat'''
! align="center" style="background:#DCDCDC;" + |[[Acute leukemia]]<ref name="OshimaYuji2013">{{cite journal|last1=Oshima|first1=Yasuo|last2=Yuji|first2=Koichiro|last3=Tanimoto|first3=Tetsuya|last4=Hinomura|first4=Yasushi|last5=Tojo|first5=Arinobu|title=Association between Acute Myelogenous Leukemia and Thrombopoietin Receptor Agonists in Patients with Immune Thrombocytopenia|journal=Internal Medicine|volume=52|issue=19|year=2013|pages=2193–2201|issn=0918-2918|doi=10.2169/internalmedicine.52.0324}}</ref><ref name="pmid24088751">{{cite journal |vauthors=Oshima Y, Yuji K, Tanimoto T, Hinomura Y, Tojo A |title=Association between acute myelogenous leukemia and thrombopoietin receptor agonists in patients with immune thrombocytopenia |journal=Intern. Med. |volume=52 |issue=19 |pages=2193–201 |date=2013 |pmid=24088751 |doi= |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|[[Alport syndrome]]<ref name="pmid8414153">{{cite journal| author=Chugh KS, Sakhuja V, Agarwal A, Jha V, Joshi K, Datta BN et al.| title=Hereditary nephritis (Alport's syndrome)--clinical profile and inheritance in 28 kindreds. | journal=Nephrol Dial Transplant | year= 1993 | volume= 8 | issue= 8 | pages= 690-5 | pmid=8414153 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8414153 }}</ref><ref name="pmid11137428">{{cite journal| author=McCarthy PA, Maino DM| title=Alport syndrome: a review. | journal=Clin Eye Vis Care | year= 2000 | volume= 12 | issue= 3-4 | pages= 139-150 | pmid=11137428 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11137428 }}</ref><ref name="pmid1425373">{{cite journal| author=Andreoli SP, Deaton M| title=Alport's syndrome. | journal=Ear Nose Throat J | year= 1992 | volume= 71 | issue= 10 | pages= 508-11 | pmid=1425373 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1425373 }}</ref><ref name="pmid8238007">{{cite journal| author=Kashtan CE, Michael AF| title=Alport syndrome: from bedside to genome to bedside. | journal=Am J Kidney Dis | year= 1993 | volume= 22 | issue= 5 | pages= 627-40 | pmid=8238007 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8238007 }}</ref><ref name="pmid8327646">{{cite journal| author=Flinter F| title=Molecular genetics of Alport's syndrome. | journal=Q J Med | year= 1993 | volume= 86 | issue= 5 | pages= 289-92 | pmid=8327646 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8327646 }}</ref><ref name="pmid14253732">{{cite journal| author=Andreoli SP, Deaton M| title=Alport's syndrome. | journal=Ear Nose Throat J | year= 1992 | volume= 71 | issue= 10 | pages= 508-11 | pmid=1425373 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1425373 }}</ref><ref name="pmid7819734">{{cite journal| author=Amari F, Segawa K, Ando F| title=Lens coloboma and Alport-like glomerulonephritis. | journal=Eur J Ophthalmol | year= 1994 | volume= 4 | issue= 3 | pages= 181-3 | pmid=7819734 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7819734 }}</ref><ref name="pmid6871140">{{cite journal| author=Govan JA| title=Ocular manifestations of Alport's syndrome: a hereditary disorder of basement membranes? | journal=Br J Ophthalmol | year= 1983 | volume= 67 | issue= 8 | pages= 493-503 | pmid=6871140 | doi= | pmc=PMC1040106 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6871140 }}</ref>
* Immune mediated
|
* [[Chromosome|Chromosomal]] abnormalities
{| class="wikitable"
| align="center" style="background:#F5F5F5;" + | +
|'''Renal'''
| align="center" style="background:#F5F5F5;" + | +
|'''Auditory'''
| align="center" style="background:#F5F5F5;" + |
|'''Ocular'''
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + |AML in adults
| align="center" style="background:#F5F5F5;" + |
* Exposure to chemicals
* [[Radiation therapy|Radiation]]
* Pre-existent blood disorders
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + |[[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
* [[Muscle weakness|Weakness]]
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |
* Blast cells
*
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
* [[Hemoglobinuria]]
| align="center" style="background:#F5F5F5;" + |Bone marrow examination
| align="center" style="background:#F5F5F5;" + |
* [[Tumor lysis syndrome]]
* [[Infection]]
* [[CNS]] involvement
* [[Disseminated intravascular coagulation|DIC]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Paroxysmal nocturnal hemoglobinuria|Paroxysmal nocturnal hemoglobinuria (PNH)]]<ref name="pmid25237200">{{cite journal| author=Brodsky RA| title=Paroxysmal nocturnal hemoglobinuria. | journal=Blood | year= 2014 | volume= 124 | issue= 18 | pages= 2804-11 | pmid=25237200 | doi=10.1182/blood-2014-02-522128 | pmc=4215311 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25237200  }}</ref>
* Hematuria
| align="center" style="background:#F5F5F5;" + |
* Proteinuria
* Deficiency of [[complement]] regulatory proteins
* Hypertension
* Reduced Creatinine Clearance
|
* Early Tinnitus
* Vertigo
* High-Frequency Progressive Bilateral Hearing Loss
|
* Refractory Error
* Posterior Polymorphous Dystrophy
* Arcus
* Glaucoma
* Vogt’s White Limbal Girdle
* Band Keratopathy
* Lenticonus
* Spherophakia
* Cataracts
* Lens Coloboma
* Anterior Lenticonus
* Flecked Retinopathy of the Macula or Periphery
|}
|
'''Vital signs'''
* [[Systemic hypertension]] may be present
'''Eyes'''
 
[[Fundoscopy]] shows:
* [[Cataract|Cataracts]]
* Subcapsular posterior lens opacities
* [[Lenticonus]]
* Retinal flecks (dot-and-fleck retinopathy)  
* Posterior polymorphous corneal dystrophy/corneal epithelial erosions
'''Ears'''
* [[Sensorineural deafness|Sensorineural hearing loss]]  
'''Extremities'''
* [[Peripheral edema]]
* [[Leiomyomatosis]]
'''Miscellaneous'''
* [[Anasarca]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
'''Urinalysis'''
* Microscopic [[hematuria]]
* [[Pyuria]]
* Red cell [[casts]]
* Cylindrical [[casts]]
* [[Proteinuria]]
'''Electrolytes and Metabolic'''
* ↑ [[Blood urea nitrogen|BUN]]
* ↑ [[Creatinine|Cr]]
* [[Hypoalbuminemia]]
|<nowiki>-</nowiki>
|'''Diagnostic criteria:'''<ref name="pmid23349312">{{cite journal| author=Savige J, Gregory M, Gross O, Kashtan C, Ding J, Flinter F| title=Expert guidelines for the management of Alport syndrome and thin basement membrane nephropathy. | journal=J Am Soc Nephrol | year= 2013 | volume= 24 | issue= 3 | pages= 364-75 | pmid=23349312 | doi=10.1681/ASN.2012020148 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23349312 }}</ref>


{| class="wikitable"
* Mutations
|'''Mandatory Criterion'''
| align="center" style="background:#F5F5F5;" + | +
|Persistent Hematuria
| align="center" style="background:#F5F5F5;" + | +
|-
| align="center" style="background:#F5F5F5;" + | −
|'''Optional Criteria'''
| align="center" style="background:#F5F5F5;" + | −
|''Presence of at Least 1 of 4'':
| align="center" style="background:#F5F5F5;" + | +
* Positive Family History of Alport's Syndrome
| align="center" style="background:#F5F5F5;" + |Any age


* Characteristic Clinical Features
(usually younger adults)
| align="center" style="background:#F5F5F5;" + |
* Sudden [[nocturnal]] [[hemoglobinuria]] with partial clearing during the day
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Thrombosis]]
* Smooth muscle [[dystonia]]
| align="center" style="background:#F5F5F5;" + |↓/Nl
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓/Nl
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |
* Cellular [[Bone marrow|marrow]]
* [[Erythroid]] [[hyperplasia]]
* [[dyserythropoiesis]]


* Characteristic Pathology Findings
* Hypocellular marrow in certain stages of the disease
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* [[Hemoglobinuria]]
| align="center" style="background:#F5F5F5;" + |[[Flow cytometry]]


* Genetic Testing
| align="center" style="background:#F5F5F5;" + |
|}
* [[Chronic renal failure]]
The equivocal or non-characteristic finding of any of the above prompts further work-up until the diagnosis is made or rejected.
* [[Pulmonary hypertension]]
* [[Aplastic anemia]]
|-
|-
| rowspan="4" |[[MYH9]]-associated disorders
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
|[[Epstein's syndrome]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
* [[epistaxis]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
* [[Gastrointestinal bleeding]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
* [[Hypertension]] (due to kidney disease)
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
* [[Deafness]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
* NO cataract
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
|<nowiki>-</nowiki>
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
|<nowiki>-</nowiki>
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
|<nowiki>-</nowiki>
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
|No [[White blood cells|leukocyte]] [[inclusion bodies]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
|<nowiki>-</nowiki>
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
| rowspan="4" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
* giant platelets on [[Blood film|PBS]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
|[[Fechtner syndrome]]
! rowspan="3" align="center" style="background:#DCDCDC;" + |Thrombotic microangiopathy (TMA)
|Same as [[Alport syndrome]]:
! align="center" style="background:#DCDCDC;" + |[[Thrombotic thrombocytopenic purpura]] ([[Thrombotic thrombocytopenic purpura|TTP]])<ref name="pmid22986360">{{cite journal |vauthors=Noris M, Mescia F, Remuzzi G |title=STEC-HUS, atypical HUS and TTP are all diseases of complement activation |journal=Nat Rev Nephrol |volume=8 |issue=11 |pages=622–33 |date=November 2012 |pmid=22986360 |doi=10.1038/nrneph.2012.195 |url=}}</ref>
* [[Sensorineural hearing loss|sensorineural deafness]]  
| align="center" style="background:#F5F5F5;" + |
* [[ocular]] abnormalities such as [[cataract]]
* Deficiency of, or antibodies to, the metalloprotease [[ADAMTS13]]  
* [[nephritis]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any age
| align="center" style="background:#F5F5F5;" + |
* Neurologic manifestations
* Fatigue due to anemia
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |[[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + |Not common
| align="center" style="background:#F5F5F5;" + |Nl or ↑
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Neurologic]] findings
* Signs of renal impairment
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl


|
or ↑
|
| align="center" style="background:#F5F5F5;" + |
|
* Fragmented [[Red blood cell|RBC]]<nowiki/>s
|
| align="center" style="background:#F5F5F5;" + |NA
* characteristic [[White blood cells|leukocyte]] [[inclusion bodies]] +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* [[Hemoglobinuria]]
| align="center" style="background:#F5F5F5;" + |Laboratory findings
| align="center" style="background:#F5F5F5;" + |
* [[Hemolysis]]
* Microvascular [[thrombosis]]
|-
! align="center" style="background:#DCDCDC;" + |[[Hemolytic-uremic syndrome|Hemolytic uremic syndrome]] ([[Hemolytic-uremic syndrome|HUS]])<ref name="pmid26396094">{{cite journal |vauthors=Conway EM |title=HUS and the case for complement |journal=Blood |volume=126 |issue=18 |pages=2085–90 |date=October 2015 |pmid=26396094 |doi=10.1182/blood-2015-03-569277 |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |
* [[Escherichia coli O157:H7]]
* Genetic defects
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Children
| align="center" style="background:#F5F5F5;" + |
* Exposure to contaminated water or milk
* Consuming undercooked ground beef
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |[[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Tenderness (medicine)|Abdominal tenderness]]
* [[Diarrhea]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl


* impaired liver function and [[hypercholesterolemia]] in some cases
or ↑
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |
* Fragmented [[Red blood cell|RBC]]<nowiki/>s
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* [[Hemoglobinuria]]
| align="center" style="background:#F5F5F5;" + |Laboratory findings
| align="center" style="background:#F5F5F5;" + |
* Acute renal failure [[Hemolysis]]
* Microvascular [[thrombosis]]
|-
|-
|May–Hegglin Anomaly
! align="center" style="background:#DCDCDC;" + |[[Disseminated intravascular coagulation|DIC]]<ref name="pmid25503977">{{cite journal |vauthors=Schwameis M, Schörgenhofer C, Assinger A, Steiner MM, Jilma B |title=VWF excess and ADAMTS13 deficiency: a unifying pathomechanism linking inflammation to thrombosis in DIC, malaria, and TTP |journal=Thromb. Haemost. |volume=113 |issue=4 |pages=708–18 |date=April 2015 |pmid=25503977 |pmc=4745134 |doi=10.1160/TH14-09-0731 |url=}}</ref><ref name="pmid20008204">{{cite journal |vauthors=Kitchens CS |title=Thrombocytopenia and thrombosis in disseminated intravascular coagulation (DIC) |journal=Hematology Am Soc Hematol Educ Program |volume= |issue= |pages=240–6 |date=2009 |pmid=20008204 |doi=10.1182/asheducation-2009.1.240 |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* Overstimulation of the coagulation system
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
* characteristic [[White blood cells|leukocyte]] [[inclusion bodies]] +
| align="center" style="background:#F5F5F5;" + | −
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any age
| align="center" style="background:#F5F5F5;" + |
* History of [[Physical trauma|trauma]], [[sepsis]], [[Cancer|malignancy]], [[vasculitis]] or [[exogenous]] [[Toxin|toxins]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Neurologic]] findings
* Signs of renal impairment
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓↓
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |
* [[Schistocytes]]
* Helmet cells
| align="center" style="background:#F5F5F5;" + |
* Low [[Platelet|platelets]]
* Low [[Red blood cell|RBCs]]
| align="center" style="background:#F5F5F5;" + |↑↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |
* [[Hemoglobinuria]]
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + laboratory findings
| align="center" style="background:#F5F5F5;" + |
* [[Hemolysis]]
* [[Microvascular disease|Microangiopathy]]
* Multi-organ dysfunction
|-
|-
|[[Sebastian platelet syndrome|Sebastian Syndrome]]
! align="center" style="background:#DCDCDC;" |Nutrient deficiencies
|same hematologic changes as those in the Fechtner syndrome but without the manifestations of [[Alport syndrome]].
! align="center" style="background:#DCDCDC;" |[[Folic Acid|Folate]], [[vitamin B12]], [[copper]] deficiencies<ref name="ClarkeWeston-Smith2010">{{cite journal|last1=Clarke|first1=V.|last2=Weston-Smith|first2=S.|title=Severe folate-deficiency pancytopenia|journal=Case Reports|volume=2010|issue=oct18 2|year=2010|pages=bcr0320102851–bcr0320102851|issn=1757-790X|doi=10.1136/bcr.03.2010.2851}}</ref><ref name="pmid23069991">{{cite journal |vauthors=Blackmer AB, Bailey E |title=Management of copper deficiency in cholestatic infants: review of the literature and a case series |journal=Nutr Clin Pract |volume=28 |issue=1 |pages=75–86 |date=February 2013 |pmid=23069991 |doi=10.1177/0884533612461531 |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* Decreased platelet production
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
* characteristic [[White blood cells|leukocyte]] [[inclusion bodies]] +
| align="center" style="background:#F5F5F5;" + | −
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any age
| align="center" style="background:#F5F5F5;" + |
* Malnutrition
* Alcohol use
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Fatigue]]
* [[Weakness]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Low [[Platelet|platelets]]
* Low [[Red blood cell|RBCs]]
| align="center" style="background:#F5F5F5;" + |
* Low [[Platelet|platelets]]
* Low [[Red blood cell|RBCs]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Laboratory findings
| align="center" style="background:#F5F5F5;" + |
* [[Megaloblastic anemia]]
|-
|-
|'''Endocrine'''
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
|[[Immunodysregulation polyendocrinopathy and enteropathy, X-linked]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
| rowspan="4" |'''Gastroenterologic'''
! rowspan="7" align="center" style="background:#DCDCDC;" + |Congenital platelet disorders<ref name="pmid22726100">{{cite journal| author=Nurden AT, Freson K, Seligsohn U| title=Inherited platelet disorders. | journal=Haemophilia | year= 2012 | volume= 18 Suppl 4 | issue=  | pages= 154-60 | pmid=22726100 | doi=10.1111/j.1365-2516.2012.02856.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22726100  }}</ref><ref name="BalduiniSavoia2012">{{cite journal|last1=Balduini|first1=Carlo L.|last2=Savoia|first2=Anna|title=Genetics of familial forms of thrombocytopenia|journal=Human Genetics|volume=131|issue=12|year=2012|pages=1821–1832|issn=0340-6717|doi=10.1007/s00439-012-1215-x}}</ref><ref name="pmid20011639">{{cite journal| author=D'Andrea G, Chetta M, Margaglione M| title=Inherited platelet disorders: thrombocytopenias and thrombocytopathies. | journal=Blood Transfus | year= 2009 | volume= 7 | issue= 4 | pages= 278-92 | pmid=20011639 | doi=10.2450/2009.0078-08 | pmc=2782805 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20011639  }}</ref>
|
! align="center" style="background:#DCDCDC;" + |[[MYH9]]-related disorders<ref name="pmid24643058">{{cite journal |vauthors=Zhang S, Zhou X, Liu S, Bai T, Zhang Y, Wang J, Wang S, Zhang X, Wang B |title=MYH9-related disease: description of a large Chinese pedigree and a survey of reported mutations |journal=Acta Haematol. |volume=132 |issue=2 |pages=193–8 |date=2014 |pmid=24643058 |doi=10.1159/000356681 |url=}}</ref>
|[[Aminoaciduria|Dibasic aminoaciduria type 2]]
| align="center" style="background:#F5F5F5;" + |
|
* [[Cytoskeleton|Cytoskeletal]] defects in [[Megakaryocyte|megakaryocytes]]
|
* Mutation
|
 
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Any age, very rare
| align="center" style="background:#F5F5F5;" + |
* Positive family history
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |
* [[Sensorineural hearing loss|Hearing loss]]
* Renal impairment
* [[Cataract]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Large [[Platelet|platelets]]
 
* Döhle body-like inclusions in peripheral blood neutrophils
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Genetic study
| align="center" style="background:#F5F5F5;" + |
* [[Dominance relationship|Autosomal dominant]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Bernard-Soulier syndrome]]<ref name="pmid21357716">{{cite journal |vauthors=Berndt MC, Andrews RK |title=Bernard-Soulier syndrome |journal=Haematologica |volume=96 |issue=3 |pages=355–9 |date=March 2011 |pmid=21357716 |pmc=3046265 |doi=10.3324/haematol.2010.039883 |url=}}</ref>
|[[liver failure]]
| align="center" style="background:#F5F5F5;" + |
|
* Absence of Gp Ib-IX-V  
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + |Children, rare
| align="center" style="background:#F5F5F5;" + |
* Positive family history
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + | Nl
| align="center" style="background:#F5F5F5;" + | Nl
| align="center" style="background:#F5F5F5;" + |
* Large [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |
* Large [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |[[Flow cytometry]]
| align="center" style="background:#F5F5F5;" + |
* [[Autosomal recessive]]
* Increased [[bleeding time]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Grey platelet syndrome|Gray platelet syndrome]]<ref name="pmid23427340">{{cite journal |vauthors=Michelson AD |title=Gray platelet syndrome |journal=Blood |volume=121 |issue=2 |pages=250 |date=January 2013 |pmid=23427340 |doi= |url=}}</ref>
|[[Niemann-Pick disease|Niemann-Pick disease type b]]
| align="center" style="background:#F5F5F5;" + |
|
* Reduction or absence of alpha-granules in [[Blood platelet|blood platelets]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + |Rare
| align="center" style="background:#F5F5F5;" + |
* Positive family history
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
Mucocutaneous
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |
* [[Epistaxis]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Large [[Platelet|platelets]] and  lack of granulation
| align="center" style="background:#F5F5F5;" + |
* [[Myelofibrosis]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Genetic study
| align="center" style="background:#F5F5F5;" + |
* [[Autosomal recessive]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Wiskott-Aldrich syndrome]]<ref name="pmid29086100">{{cite journal |vauthors=Candotti F |title=Clinical Manifestations and Pathophysiological Mechanisms of the Wiskott-Aldrich Syndrome |journal=J. Clin. Immunol. |volume=38 |issue=1 |pages=13–27 |date=January 2018 |pmid=29086100 |doi=10.1007/s10875-017-0453-z |url=}}</ref>
|[[portal hypertension]]
| align="center" style="background:#F5F5F5;" + |
|
* Mutation in [[GATA1|GATA-1]]  
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + |Rare
| align="center" style="background:#F5F5F5;" + |
* Positive family history
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |
* [[Eczema]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Bloody diarrhea
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Small but low [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |
* Small but low [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Genetic study
| align="center" style="background:#F5F5F5;" + |
* Recurrent [[Infection|infections]]
 
* [[Autoimmune disease|autoimmune disorders]]
* [[Cancer|Malignancy]]
|-
|-
| rowspan="12" |'''Genetic'''
! align="center" style="background:#DCDCDC;" + |Thrombocytopenia with absent radius (TAR) syndrome<ref name="pmid27981927">{{cite journal |vauthors=Al-Qattan MM |title=The Pathogenesis of Radial Ray Deficiency in Thrombocytopenia-Absent Radius (TAR) Syndrome |journal=J Coll Physicians Surg Pak |volume=26 |issue=11 |pages=912–916 |date=November 2016 |pmid=27981927 |doi=2476 |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|[[Aicardi-Goutieres syndrome]]
* 1q21.1 [[Deletion (genetics)|deletion]] and [[bone marrow]] failure
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + |Children
|
| align="center" style="background:#F5F5F5;" + |
* Positive family history
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
* Bilateral [[Radius (bone)|radial]] aplasia
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl or ↑
| align="center" style="background:#F5F5F5;" + |
* Normal size [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |
* Normal or hypercellular [[bone marrow]]
* Decreased, absent, or immature [[Megakaryocyte|megakaryocytes]]
* Small, [[basophilic]], vacuolated [[Megakaryocyte|megakaryocytes]]
* [[Erythroid]] [[hyperplasia]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Evidence of absent radius
+
 
Laboratory findings
| align="center" style="background:#F5F5F5;" + |
* Cow's milk allergy
* Various other anomalies
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Fechtner syndrome]]<ref name="pmid10577925">{{cite journal |vauthors=Toren A, Amariglio N, Rozenfeld-Granot G, Simon AJ, Brok-Simoni F, Pras E, Rechavi G |title=Genetic linkage of autosomal-dominant Alport syndrome with leukocyte inclusions and macrothrombocytopenia (Fechtner syndrome) to chromosome 22q11-13 |journal=Am. J. Hum. Genet. |volume=65 |issue=6 |pages=1711–7 |date=December 1999 |pmid=10577925 |pmc=1288382 |doi=10.1086/302654 |url=}}</ref>
|[[Chediak-Higashi disease]]
| align="center" style="background:#F5F5F5;" + |
|
* Mutation of chromosome 22q11-13
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + |Children
| align="center" style="background:#F5F5F5;" + |
* Positive family history
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |
* [[Bruise|Ecchymoses]] and
[[petechia]]
| align="center" style="background:#F5F5F5;" + | + [[Mucocutaneous zone|Mucocutaneous]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |
* Hearing loss
* Eye abnormalities
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl or ↑
| align="center" style="background:#F5F5F5;" + |
* Large [[Platelet|platelets]]
* Granulocytic inclusions
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* [[Hematuria|Microscopic hematuria]]
* [[Pyuria]]
* [[Hematuria|Red cell]] [[casts]]
* [[Hematuria|Cylindrical]] [[casts]]
* [[Proteinuria]]
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + genetic study
| align="center" style="background:#F5F5F5;" + |
* [[Dominance relationship|Autosomal dominant]] variant of [[Alport syndrome]]
* [[Renal insufficiency|Renal failure]]
* [[Hypoalbuminemia]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Von Willebrand disease]]<ref name="pmid24337418">{{cite journal |vauthors=Langer F, Obser T, Oyen F, Spath B, Holstein K, Greinacher A, White JG, Budde U, Bokemeyer C, Schneppenheim R |title=Characterisation of the p.A1461D mutation causing von Willebrand disease type 2B with severe thrombocytopenia, circulating giant platelets, and defective α-granule secretion |journal=Thromb. Haemost. |volume=111 |issue=4 |pages=777–9 |date=April 2014 |pmid=24337418 |doi=10.1160/TH13-06-0462 |url=}}</ref>
|[[Factor H|complement factor H deficiency]]
| align="center" style="background:#F5F5F5;" + |
|
* [[Von Willebrand factor|VWF]] deficiency/dysfunction
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Rarely
|
| align="center" style="background:#F5F5F5;" + |More common with [[ABO blood group system|O blood type]]
| align="center" style="background:#F5F5F5;" + |
* Positive family history
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl/ ↓
| align="center" style="background:#F5F5F5;" + |Nl/↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Large [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl or ↑
| align="center" style="background:#F5F5F5;" + |
* [[Hematuria]]
| align="center" style="background:#F5F5F5;" + |Laboratory findings
| align="center" style="background:#F5F5F5;" + |
* Lifelong bleeding disorder
|-
|-
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
|[[Fanconi anaemia]]
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
|
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rheumatologic/autoimmune disorders
|[[Fechtner syndrome]]
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Idiopathic thrombocytopenic purpura|ITP]]<ref name="ZuffereyKapur2017">{{cite journal|last1=Zufferey|first1=Anne|last2=Kapur|first2=Rick|last3=Semple|first3=John|title=Pathogenesis and Therapeutic Mechanisms in  Immune Thrombocytopenia (ITP)|journal=Journal of Clinical Medicine|volume=6|issue=2|year=2017|pages=16|issn=2077-0383|doi=10.3390/jcm6020016}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* Immune-mediated [[platelet]] destruction
|
* Inhibition of [[platelet]] release from the [[megakaryocyte]]  
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any age
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Bruise|Ecchymoses]] and
[[petechia]]
| align="center" style="background:#F5F5F5;" + | + [[Mucocutaneous zone|Mucocutaneous]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓↓↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Large [[Platelet|platelets]], otherwise normal
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Diagnosis of exclusion
| align="center" style="background:#F5F5F5;" + |
* Spontaneous remission  
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Systemic lupus erythematosus]]<ref name="pmid27777394">{{cite journal |vauthors=Abu-Hishmeh M, Sattar A, Zarlasht F, Ramadan M, Abdel-Rahman A, Hinson S, Hwang C |title=Systemic Lupus Erythematosus Presenting as Refractory Thrombotic Thrombocytopenic Purpura: A Diagnostic and Management Challenge. A Case Report and Concise Review of the Literature |journal=Am J Case Rep |volume=17 |issue= |pages=782–787 |date=October 2016 |pmid=27777394 |pmc=5083062 |doi= |url=}}</ref>
|[[holocarboxylase synthase deficiency]]
| align="center" style="background:#F5F5F5;" + |
|
* Immune-mediated [[platelet]] destruction
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Young women, more prevalent in Africans and Asians
|-
| align="center" style="background:#F5F5F5;" + |
|
* Medication use
|[[iminodipeptiduria]]
* History of [[Weight change|weight changes]]
|
* Other [[Rheumatologic disease|rheumatologic]] and [[autoimmune diseases]]
|
* [[Family history]] of [[Rheumatologic disease|rheumatologic diseases]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |[[Malar rash]], generalized [[maculopapular rash]], discoid rash
|
| align="center" style="background:#F5F5F5;" + | +
|
 
|
[[Hemoptysis]]
|-
| align="center" style="background:#F5F5F5;" + |Nl or ↑
|
| align="center" style="background:#F5F5F5;" + | +
|[[Jacobsen syndrome]]
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |
|
* Mucosal ulcers
|
* [[Lymphadenopathy]]
|
* [[Rales|Crackles]]
|
* Chest [[tenderness]]
|
* [[Heart murmur|Murmur]]
|
* [[Hepatomegaly]]
* [[Cognitive impairment]]
 
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |
** [[Hematuria]]
** [[Pyuria]]
** [[Proteinuria]]
** Cellular casts
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + serology
| align="center" style="background:#F5F5F5;" + |
* [[Thrombotic thrombocytopenic purpura|TTP]]
* Multiorgan dysfunction
* [[Infections]]
* [[Atherosclerosis]]
* [[Malignancies]]
* Poor prognosis with lupus nephritis
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Antiphospholipid syndrome]]<ref name="Artim-EsenDiz-Küçükkaya2015">{{cite journal|last1=Artim-Esen|first1=Bahar|last2=Diz-Küçükkaya|first2=Reyhan|last3=İnanç|first3=Murat|title=The Significance and Management of Thrombocytopenia in Antiphospholipid Syndrome|journal=Current Rheumatology Reports|volume=17|issue=3|year=2015|issn=1523-3774|doi=10.1007/s11926-014-0494-8}}</ref>
|[[MELAS]]
| align="center" style="background:#F5F5F5;" + |
|
* Autoantibody-mediated syndrome
'''Early symptoms:'''
| align="center" style="background:#F5F5F5;" + | −
* [[Muscle weakness]]
| align="center" style="background:#F5F5F5;" + | +
* [[Muscle pain]]
| align="center" style="background:#F5F5F5;" + | −
* Recurrent [[headaches]]
| align="center" style="background:#F5F5F5;" + | +
* [[Loss of appetite]]
| align="center" style="background:#F5F5F5;" + | +
* [[Vomiting]]
| align="center" style="background:#F5F5F5;" + |Middle aged women, more in African American and Hispanic population
* [[Seizures]]
| align="center" style="background:#F5F5F5;" + |
* [[Abdominal pain]]
* Abortion
* Extreme tiredness ([[fatigue]])
* Other [[Rheumatologic disease|rheumatologic]] and [[autoimmune diseases]]
* [[Difficulty breathing]]
* [[Family history]] of [[Rheumatologic disease|rheumatologic diseases]]
'''Eye'''
| align="center" style="background:#F5F5F5;" + | −
* Vision abnormalities
| align="center" style="background:#F5F5F5;" + | −
'''Ear'''
| align="center" style="background:#F5F5F5;" + | −
* [[Hearing loss]]
| align="center" style="background:#F5F5F5;" + |Nl
'''Extremeties'''
| align="center" style="background:#F5F5F5;" + | −
* [[Myoclonus]]
| align="center" style="background:#F5F5F5;" + | −
'''Neurologic'''
| align="center" style="background:#F5F5F5;" + |
* [[Stroke]]-like episodes beginning before age 40
* [[Deep vein thrombosis|DVT]]
* Temporary [[muscle weakness]] on one side of the body ([[hemiparesis]])
| align="center" style="background:#F5F5F5;" + |↓
* [[Confusion|Altered consciousness]]
| align="center" style="background:#F5F5F5;" + |Nl
* [[Ataxia]]
| align="center" style="background:#F5F5F5;" + |↓
* [[Seizures]]
| align="center" style="background:#F5F5F5;" + |
* [[Dementia]]
* Reduced [[Platelet|platelets]] and [[White blood cells|WBC]]
|
| align="center" style="background:#F5F5F5;" + |
|
* Reduced [[Platelet|platelets]] and [[White blood cells|WBC]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |↑
* [[lactic acidosis]]
| align="center" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Hematuria]]
|
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + repeated positive tests of aPL
| align="center" style="background:#F5F5F5;" + |
* Recurrent [[thrombosis]]
* [[Stroke]]
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Felty's syndrome]]<ref name="ChavalitdhamrongMolovic-Kokovic2009">{{cite journal|last1=Chavalitdhamrong|first1=Disaya|last2=Molovic-Kokovic|first2=Ana|last3=Iliev|first3=Andrey|title=Felty's Syndrome as an initial presentation of Rheumatoid Arthritis: a case report|journal=Cases Journal|volume=2|issue=1|year=2009|pages=206|issn=1757-1626|doi=10.1186/1757-1626-2-206}}</ref>
|[[Omenn syndrome]]
| align="center" style="background:#F5F5F5;" + |
|
* Autoantibody-mediated syndrome
|
* [[Splenomegaly]]
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | ±
|
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Rare, young women
| align="center" style="background:#F5F5F5;" + |
* [[Arthritis]]
* Family history of [[Rheumatoid arthritis|RA]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Necrosis|Necrotizing]] skin lesions
* [[Rheumatoid nodule]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* Lymphadenopathy
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]] and [[White blood cells|WBC]]
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]] and [[White blood cells|WBC]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Clinical manifestation
| align="center" style="background:#F5F5F5;" + |
* [[Rheumatoid arthritis]]
* Positive [[Rheumatoid factor|RF]] and anti-citrullinated peptide antibodies
* [[Episcleritis]]
* Pleuropericarditis
|-
|-
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
|[[TAR syndrome]]
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
|Absent [[Radius (bone)|radius]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
|
! rowspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infection-induced
|[[X-linked hyperimmunoglobulin M syndrome]]
! rowspan="3" align="center" style="background:#DCDCDC;" + |[[Infection|Bacterial infections]]
|
! align="center" style="background:#DCDCDC;" + |[[Sepsis]]<ref name="WuRen2014">{{cite journal|last1=Wu|first1=Qin|last2=Ren|first2=Jianan|last3=Wu|first3=Xiuwen|last4=Wang|first4=Gefei|last5=Gu|first5=Guosheng|last6=Liu|first6=Song|last7=Wu|first7=Yin|last8=Hu|first8=Dong|last9=Zhao|first9=Yunzhao|last10=Li|first10=Jieshou|title=Recombinant human thrombopoietin improves platelet counts and reduces platelet transfusion possibility among patients with severe sepsis and thrombocytopenia: A prospective study|journal=Journal of Critical Care|volume=29|issue=3|year=2014|pages=362–366|issn=08839441|doi=10.1016/j.jcrc.2013.11.023}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* Direct [[bone marrow suppression]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any
| align="center" style="background:#F5F5F5;" + |
* [[Infection|Bacterial infection]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Petechiae]]
* [[Purpura]]
* [[Erythema]]
* [[Ulcer|Ulceration]]
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + |Nl to ↓
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | ±
| align="center" style="background:#F5F5F5;" + |
* [[Malaise]]
* [[Lymphadenopathy]]
| align="center" style="background:#F5F5F5;" + |↓/↑
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |↑↑
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + | +
Depends on the etiology
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + culture
| align="center" style="background:#F5F5F5;" + |
* Associated with ↑ mortality
|-
|-
| rowspan="33" |'''Hematologic'''
! align="center" style="background:#DCDCDC;" + |[[Helicobacter pylori]]<ref name="pmid24574745">{{cite journal |vauthors=Kuwana M |title=Helicobacter pylori-associated immune thrombocytopenia: clinical features and pathogenic mechanisms |journal=World J. Gastroenterol. |volume=20 |issue=3 |pages=714–23 |date=January 2014 |pmid=24574745 |pmc=3921481 |doi=10.3748/wjg.v20.i3.714 |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|[[Acquired pure megakaryocytic aplasia]]
* Immune thrombocytopenia
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Any
|
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |
* Epigastric tenderness
* [[Heartburn]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + culture
| align="center" style="background:#F5F5F5;" + |
* [[Gastroesophageal reflux disease|GERD]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Tick-borne disease|Tick-borne infection]]<ref name="pmid24837566">{{cite journal |vauthors=Liu Q, He B, Huang SY, Wei F, Zhu XQ |title=Severe fever with thrombocytopenia syndrome, an emerging tick-borne zoonosis |journal=Lancet Infect Dis |volume=14 |issue=8 |pages=763–772 |date=August 2014 |pmid=24837566 |doi=10.1016/S1473-3099(14)70718-2 |url=}}</ref>
|[[aplastic anemia]]
| align="center" style="background:#F5F5F5;" + |
|
* Immune thrombocytopenia
|
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+ / </nowiki>
| align="center" style="background:#F5F5F5;" + | +
|<nowiki>+ / </nowiki>
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Endemic area like China, Japan, and Korea
| align="center" style="background:#F5F5F5;" + |
* Being bitten by a tick
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Petechiae]]
* [[Purpura]]
* [[Erythema]]
* [[Ulcer|Ulceration]]
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |Nl to ↓
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |
* [[Encephalitis]]
* [[Viral hemorrhagic fever|Hemorrhagic fever]]
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* [[Proteinuria]]
| align="center" style="background:#F5F5F5;" + |[[Polymerase chain reaction|PCR]]
| align="center" style="background:#F5F5F5;" + |
* Elevated [[Alanine transaminase|ALT]] and [[Aspartate transaminase|AST]]
* [[Multiple organ dysfunction syndrome|Multiple organ failure]]
* [[Lymphadenopathy]]
|-
|-
|
! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Virus|Viral infections]]
|[[Bernard-Soulier syndrome]]
! align="center" style="background:#DCDCDC;" + |[[Human Immunodeficiency Virus (HIV)|HIV]]<ref name="pmid26098601">{{cite journal |vauthors=Borges ÁH, Lundgren JD, Mocroft A |title=Thrombocytopenia and cancer risk during HIV infection |journal=AIDS |volume=29 |issue=11 |pages=1425–7 |date=July 2015 |pmid=26098601 |doi=10.1097/QAD.0000000000000744 |url=}}</ref>
|
| align="Left" style="background:#F5F5F5;" + |
|
* Immune thrombocytopenia
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any
| align="center" style="background:#F5F5F5;" + |
* High risk behaviors
* Close contact
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Skin lesions]]
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |Nl to ↓
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |
* [[Lymphadenopathy]]
* [[Muscle weakness]]
* [[Joint swelling]]
* Focal neurological deficits
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |
* [[Proteinuria]]
| align="center" style="background:#F5F5F5;" + |Isolation of [[Human Immunodeficiency Virus (HIV)|HIV]]
| align="center" style="background:#F5F5F5;" + |
* [[Cancer|Malignancy]]
* Severe [[immunodeficiency]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |Other viruses such as [[rubella]], [[mumps]], [[varicella]], [[parvovirus]], [[hepatitis C]], & [[Epstein Barr virus|Epstein-Barr virus]]<ref name="pmid25518779">{{cite journal |vauthors=Saeed M, Dabbagh O, Al-Muhaizae M, Dhalaan H, Chedrawi A |title=Acute disseminated encephalomyelitis and thrombocytopenia following Epstein-Barr virus infection |journal=J Coll Physicians Surg Pak |volume=24 Suppl 3 |issue= |pages=S216–8 |date=November 2014 |pmid=25518779 |doi=11.2014/JCPSP.S216S218 |url=}}</ref>
|[[Thrombocytopenia|congenital amegakaryocytic thrombocytopenia (CAMT)]]
| align="center" style="background:#F5F5F5;" + |
|
* Immune thrombocytopenia
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Any
| align="center" style="background:#F5F5F5;" + |
* High risk behaviors
* Close contact
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Petechiae]]
* [[Purpura]]
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |
* [[Lymphadenopathy]]
* [[Muscle weakness]]
* [[Joint swelling]]
* Focal neurological deficits
* Depends on etiology
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* [[Hematuria]]
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + lab tests
| align="center" style="background:#F5F5F5;" + |
* Depends on etiology
* [[Encephalomyelitis]]
|-
|-
|
! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Parasitism|Parasitic infections]]
|[[disseminated intravascular coagulation]]
! align="center" style="background:#DCDCDC;" + |[[Malaria]]<ref name="pmid25131143">{{cite journal |vauthors=Rodriguez-Morales AJ, Giselle-Badillo A, Manrique-Castaño S, Yepes MC |title=Anemia and thrombocytopenia in Plasmodium vivax malaria is not unusual in patients from endemic and non-endemic settings |journal=Travel Med Infect Dis |volume=12 |issue=5 |pages=549–50 |date=2014 |pmid=25131143 |doi=10.1016/j.tmaid.2014.07.006 |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* Unknown
|
* Immune thrombocytopenia
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Endemic area
| align="center" style="background:#F5F5F5;" + |
* Being bitten by a mosquito
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |Nl to ↓
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |
* [[Headache]]
* [[Weakness]]
* [[Night sweats]]
* [[Joint pain]]
* [[Muscle pain]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |
* [[Pancytopenia]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* [[Hematuria]]
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + microscopic examination of blood smear
| align="center" style="background:#F5F5F5;" + |
* Life-threatening disease
* [[Multiple organ dysfunction syndrome|Multiple organ failure]]
|-
|-
|
! align="center" style="background:#DCDCDC;" + |[[Babesiosis]]<ref name="pmid24783256">{{cite journal |vauthors=Nackos E, DeSancho M |title=Anemia and thrombocytopenia: diagnosis from the blood smear |journal=Blood |volume=123 |issue=12 |pages=1783 |date=March 2014 |pmid=24783256 |doi= |url=}}</ref>
|[[Epstein's syndrome]]
| align="center" style="background:#F5F5F5;" + |
|
* Unknown
|
* Immune thrombocytopenia
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + | +
|-
| align="center" style="background:#F5F5F5;" + |Rare
|
| align="center" style="background:#F5F5F5;" + |
|[[familial histiocytic reticulosis]]
* Being bitten by a tick
|
* [[Immunodeficiency]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + |±
|
| align="center" style="background:#F5F5F5;" + |Nl to ↓
|
| align="center" style="background:#F5F5F5;" + |±
|
| align="center" style="background:#F5F5F5;" + |±
|-
| align="center" style="background:#F5F5F5;" + |
|
* [[Fatigue]]
|[[Gasser syndrome]]
* [[Rigor|Chills]]
|
* [[Perspiration|Sweats]]
|
* [[Headache]]
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + |
|
* [[Pancytopenia]]
|-
| align="center" style="background:#F5F5F5;" + |
|
* [[Pancytopenia]]
|[[GATA1|GATA1-related cytopenia]]
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |
|
* [[Hematuria]]
|
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + microscopic examination of blood smear
|
| align="center" style="background:#F5F5F5;" + |
|
* Severe hemolytic anemia
|
* [[Disseminated intravascular coagulation|DIC]]
|-
* [[Multiple organ dysfunction syndrome|Multiple organ failure]]
|
|[[Glanzmann's thrombasthenia]]
|
|
|
|
|
|
|
|-
|
|[[grey platelet syndrome]]
|
|
|
|
|
|
|
|-
|
|[[hemolytic uremic syndrome]]
|
|
|
|
|
|
|
|-
|
|[[histiocytosis X]]
|
|
|
|
|
|
|
|-
|
|[[hypersplenism]]
|
|
|
|
|
|
|
|-
|
|[[idiopathic thrombocytopenic purpura]]
|
|
|
|
|
|
|
|-
|
|[[Jacobsen syndrome]]
|
|
|
|
|
|
|
|-
|
|[[Kasabach-Merritt syndrome]]
|
|
|
|
|
|
|
|-
|
|[[May-Hegglin anomaly]]
|
|
|
|
|
|
|
|-
|
|[[Moschcowitz syndrome]]
|
|
|
|
|
|
|
|-
|
|[[myelodysplastic syndrome]]
|
|
|
|
|
|
|
|-
|
|[[myelofibrosis]]
|
|
|
|
|
|
|
|-
|
|[[neonatal alloimmune thrombocytopenia]]
|
|
|
|
|
|
|
|-
|
|[[pancytopenia]]
|
|
|
|
|
|
|
|-
|
|Paris-Trousseau thrombocytopenia
|
|
|
|
|
|
|
|-
|
|[[paroxysmal nocturnal hemoglobinuria]]
|
|
|
|
|
|
|
|-
|
|[[post-transfusion purpura]]
|
|
|
|
|
|
|
|-
|
|[[TAR syndrome|radial aplasia-thrombocytopenia syndrome]]
|
|
|
|
|
|
|
|-
|
|[[Sebastian platelet syndrome]]
|
|
|
|
|
|
|
|-
|
|[[Shwachman-Diamond syndrome]]
|
|
|
|
|
|
|
|-
|
|[[thrombotic thrombocytopenic purpura]]
|
|
|
|
|
|
|
|-
|
|[[Von Willebrand disease|Von Willebrand disease, platelet type]]
|
|
|
|
|
|
|
|-
|
|[[Werlhof disease]]
|
|
|
|
|
|
|
|-
|
|[[Wiskott-Aldrich syndrome]]
|
|
|
|
|
|
|
|-
| rowspan="5" |'''Iatrogenic'''
|
|[[Coronary artery bypass surgery|Cardiac bypass]]
|
|
|
|
|
|
|
|-
|
|[[chemotherapy]]
|
|
|
|
|
|
|
|-
|
|[[Intra-aortic balloon pump|intra-aortic balloon pump placement]]
|
|
|
|
|
|
|
|-
|
|[[Blood transfusion|massive blood transfusion]]
|
|
|
|
|
|
|
|-
|
|[[radiation therapy]]
|
|
|
|
|
|
|
|-
| rowspan="25" |'''Infectious diseases'''
|
|[[Congenital syphilis]]
|
|
|
|
|
|
|
|-
|
|[[cytomegalovirus]]
|
|
|
|
|
|
|
|-
|
|[[Dengue fever]]
|
|
|
|
|
|
|
|-
|
|[[ehrlichiosis]]
|
|
|
|
|
|
|
|-
|
|[[Epstein-Barr virus]]
|
|
|
|
|
|
|
|-
|
|[[hantavirus]]
|
|
|
|
|
|
|
|-
|
|[[hepatitis C]]
|
|
|
|
|
|
|
|-
|
|[[HIV]]
|
|
|
|
|
|
|
|-
|
|[[human granulocytic ehrlichiosis]]
|
|
|
|
|
|
|
|-
|
|[[Ehrlichiosis|human monocytotropic ehrlichiosis]]
|
|
|
|
|
|
|
|-
|
|[[lassa fever]]
|
|
|
|
|
|
|
|-
|
|[[leptospirosis]]
|
|
|
|
|
|
|
|-
|
|[[malaria]]
|
|
|
|
|
|
|
|-
|
|[[measles]]
|
|
|
|
|
|
|
|-
|
|[[mumps]]
|
|
|
|
|
|
|
|-
|
|[[mycoplasma pneumonia]]
|
|
|
|
|
|
|
|-
|
|[[Relapsing fever|Oklahoma tick fever]]
|
|
|
|
|
|
|
|-
|
|[[parvovirus]]
|
|
|
|
|
|
|
|-
|
|[[Q fever]]
|
|
|
|
|
|
|
|-
|
|[[rubella]]
|
|
|
|
|
|
|
|-
|
|sepsis
|
|
|
|
|
|
|
|-
|
|[[tick-borne encephalitis]]
|
|
|
|
|
|
|
|-
|
|[[Toxic shock syndrome|toxic shock syndrome (staphylococcal)]]
|
|
|
|
|
|
|
|-
|
|[[varicella]]
|
|
|
|
|
|
|
|-
|
|[[visceral leishmaniasis]]
|
|
|
|
|
|
|
|-
| rowspan="14" |'''Nutritional/Metabolic'''
|
|[[folate deficiency]]
|
|
|
|
|
|
|
|-
|
|[[Gaucher disease]]
|
|
|
|
|
|
|
|-
|
|[[holocarboxylase synthase deficiency]]
|
|
|
|
|
|
|
|-
|
|[[iminodipeptiduria]]
|
|
|
|
|
|
|
|-
|
|[[iron deficiency]]
|
|
|
|
|
|
|
|-
|
|[[isovaleric acidaemia]]
|
|
|
|
|
|
|
|-
|
|[[Methylmalonic aciduria|methylmalonic aciduria type 2]]
|
|
|
|
|
|
|
|-
|
|[[CD36|platelet glycoprotein 4 deficiency]]
|
|
|
|
|
|
|
|-
|
|[[platelet glycoprotein Ib deficiency]]
|
|
|
|
|
|
|
|-
|
|[[prolidase deficiency]]
|
|
|
|
|
|
|
|-
|
|[[propionyl-CoA carboxylase deficiency]]
|
|
|
|
|
|
|
|-
|
|[[sea blue histiocytosis]]
|
|
|
|
|
|
|
|-
|
|[[sitosterolemia]]
|
|
|
|
|
|
|
|-
|
|[[vitamin B12 deficiency]]
|
|
|
|
|
|
|
|-
| rowspan="2" |'''Obstetric/Gynecologic'''
|
|[[Eclampsia]], [[pre-eclampsia]]
|
|
|
|
|
|
|
|-
|
|[[HELLP syndrome]]
|
|
|
|
|
|
|
|-
| rowspan="11" |'''Oncologic'''
|
|[[Acute lymphoblastic leukemia]]
|
|
|
|
|
|
|
|-
|
|[[acute myeloid leukemia]]
|
|
|
|
|
|
|
|-
|
|[[acute promyelocytic leukemia]]
|
|
|
|
|
|
|
|-
|
|[[chronic lymphocytic leukaemia]]
|
|
|
|
|
|
|
|-
|
|[[chronic myeloid leukaemia]]
|
|
|
|
|
|
|
|-
|
|[[hairy cell leukaemia]]
|
|
|
|
|
|
|
|-
|
|[[hepatosplenic T-cell lymphoma]]
|
|
|
|
|
|
|
|-
|
|[[lymphoma]]
|
|
|
|
|
|
|
|-
|
|[[myeloma]]
|
|
|
|
|
|
|
|-
|-
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
|[[Non-Hodgkins lymphoma]]
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
|
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Medication/toxicity
|[[paraneoplastic syndrome]]
! align="center" style="background:#DCDCDC;" + |[[Antibiotic|Antibiotics]]/
|
[[Anticonvulsant|Antiepileptic]]<ref name="pmid17666285">{{cite journal |vauthors=Visentin GP, Liu CY |title=Drug-induced thrombocytopenia |journal=Hematol. Oncol. Clin. North Am. |volume=21 |issue=4 |pages=685–96, vi |date=August 2007 |pmid=17666285 |pmc=1993236 |doi=10.1016/j.hoc.2007.06.005 |url=}}</ref>
|
! align="left" style="background:#DCDCDC;" + |
|
* [[Quinine]]
|
* [[Sulfonamide (medicine)|Sulfonamides]]
|
* [[Carbamazepine]]
|
* [[Phenytoin]]
|
| align="center" style="background:#F5F5F5;" + |
* Occurrence of drug-dependent, platelet-reactive [[antibodies]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any
| align="center" style="background:#F5F5F5;" + |
* Drug ingestion or injection
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Bruise|Ecchymoses]]
* [[Petechia]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + exclusion of the other causes
| align="center" style="background:#F5F5F5;" + |NA
|-
|-
| rowspan="2" |'''Overdose/Toxicity'''
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Heparin-induced thrombocytopenia]]<ref name="Lovecchio2014">{{cite journal|last1=Lovecchio|first1=F.|title=Heparin-induced thrombocytopenia|journal=Clinical Toxicology|volume=52|issue=6|year=2014|pages=579–583|issn=1556-3650|doi=10.3109/15563650.2014.917181}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|[[ethanol]]
* Anti-heparin/PF4 antibody 
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Any
|
| align="center" style="background:#F5F5F5;" + |
* Heparin injection
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* Necrotic skin lesions
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |[[Enzyme linked immunosorbent assay (ELISA)|ELISA]]
| align="center" style="background:#F5F5F5;" + |
* Early or delayed-onset
* [[Thrombosis]]
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Chemotherapy|Cytotoxic chemotherapy]]<ref name="ParameswaranLunning2014">{{cite journal|last1=Parameswaran|first1=R.|last2=Lunning|first2=M.|last3=Mantha|first3=S.|last4=Devlin|first4=S.|last5=Hamilton|first5=A.|last6=Schwartz|first6=G.|last7=Soff|first7=G.|title=Romiplostim for management of chemotherapy-induced thrombocytopenia|journal=Supportive Care in Cancer|volume=22|issue=5|year=2014|pages=1217–1222|issn=0941-4355|doi=10.1007/s00520-013-2074-2}}</ref>
|[[arsenic trioxide]]
| align="center" style="background:#F5F5F5;" + |
|
* [[Bone marrow suppression]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Patients with [[Cancer|malignancy]]
| align="center" style="background:#F5F5F5;" + |
* Drug ingestion or injection
* [[Cancer]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Bruise|Ecchymoses]]
* Petechia
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |
* Megakaryocytic hypoplasia or aplasia
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |[[Hematuria case study one|Hematuria]]
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + exclusion of the other causes
| align="center" style="background:#F5F5F5;" + |
* [[Thrombosis]]
|-
|-
|'''Pulmonary'''
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Radiation therapy]]<ref name="pmid23233625">{{cite journal |vauthors=Bercovitz RS, Josephson CD |title=Thrombocytopenia and bleeding in pediatric oncology patients |journal=Hematology Am Soc Hematol Educ Program |volume=2012 |issue= |pages=499–505 |date=2012 |pmid=23233625 |doi=10.1182/asheducation-2012.1.499 |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|[[Acute respiratory distress syndrome]]
* Predictable, dose-dependent [[Bone marrow suppression|myelosuppression]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Patients with [[Cancer|malignancy]]
|
| align="center" style="background:#F5F5F5;" + |
* [[Radiation therapy|Radiation]]
* [[Cancer]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Purpura]]
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |
* Megakaryocytic hypoplasia or aplasia
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |[[Hematuria case study one|Hematuria]]
| align="center" style="background:#F5F5F5;" + |Clinical manifestation + exclusion of the other causes
| align="center" style="background:#F5F5F5;" + |
* [[Thrombosis]]
|-
|-
|'''Renal/Electrolyte'''
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |GI
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Chronic liver disease]]<ref name="LoffredoVioli20182">{{cite journal|last1=Loffredo|first1=Lorenzo|last2=Violi|first2=Francesco|title=Thrombopoietin receptor agonists and risk of portal vein thrombosis in patients with liver disease and thrombocytopenia: A meta-analysis|journal=Digestive and Liver Disease|year=2018|issn=15908658|doi=10.1016/j.dld.2018.06.005}}</ref>
|[[hemolytic uremic syndrome]]
| align="center" style="background:#F5F5F5;" + |
|
* [[Bone marrow suppression]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + |
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Any
| align="center" style="background:#F5F5F5;" + |
* [[Cirrhosis]]
* [[Alcoholism|Alcohol use]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Purpura]]
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |[[Biopsy]]
| align="center" style="background:#F5F5F5;" + |
* [[Portal vein thrombosis]]
* [[Hepatorenal syndrome]]
* Variceal hemorrhage
* Hepatic [[hydrothorax]]
* [[Spontaneous bacterial peritonitis]]
|-
|-
| rowspan="10" |'''Rheumatology/Immunology/Allergy'''
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Portal hypertension]]<ref name="pmid17729421">{{cite journal |vauthors=Jia YP, Lu Q, Gong S, Ma BY, Wen XR, Peng YL, Lin L, Chen HY, Qiu L, Luo Y |title=Postoperative complications in patients with portal vein thrombosis after liver transplantation: evaluation with Doppler ultrasonography |journal=World J. Gastroenterol. |volume=13 |issue=34 |pages=4636–40 |date=September 2007 |pmid=17729421 |pmc=4611842 |doi= |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|[[Anticardiolipin syndrome]]
* [[Bone marrow suppression]]
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Any
|
| align="center" style="background:#F5F5F5;" + |
* [[Cirrhosis]]
* [[Alcoholism|Alcohol use]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Purpura]]
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |
* Reduced [[Platelet|platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Clinical manifestation
| align="center" style="background:#F5F5F5;" + |
* [[Portal vein thrombosis]]
* [[Ascites]]
|-
|-
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
|[[antiphospholipid syndrome]]
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
|-
|
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Vascular
|[[autoimmune lymphoproliferative syndrome type 1]]
! colspan="2" align="center" style="background:#DCDCDC;" + |Giant capillary hemangioma ([[Kasabach-Merritt syndrome]])<ref>Lewis D, Vaidya R. Kasabach Merritt Syndrome. [Updated 2018 Jul 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www-ncbi-nlm-nih-gov.ezp-prod1.hul.harvard.edu/books/NBK519053/</ref><ref name="VinodJohny2017">{{cite journal|last1=Vinod|first1=Kolar Vishwanath|last2=Johny|first2=Joseph|last3=Vadivelan|first3=Mehalingam|last4=Hamide|first4=Abdoul|title=Kasabach-Merritt Syndrome in an adult|journal=Turkish Journal of Hematology|year=2017|issn=13007777|doi=10.4274/tjh.2017.0429}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* [[Platelet]] destruction
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Infants
| align="center" style="background:#F5F5F5;" + |
* Rare but serious infantile [[coagulopathy]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* Multiple purple [[hemangioma]]
| align="center" style="background:#F5F5F5;" + | Intralesional [[bleeding]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Visceral hemangiomas
| align="center" style="background:#F5F5F5;" + |↓↓
| align="center" style="background:#F5F5F5;" + |↓↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Normocytic normochromic [[erythrocytes]] and markedly reduced [[platelets]]
| align="center" style="background:#F5F5F5;" + |Normal [[erythropoiesis]], myelopoiesis, and megakaryocytic hyperplasia
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |[[Hematuria case study one|Hematuria]]
| align="center" style="background:#F5F5F5;" + |[[Biopsy]]
| align="center" style="background:#F5F5F5;" + |
* Kaposiform hemangioendothelioma
* Tufted angioma
*
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cardiopulmonary bypass]]<ref name="JiKim2015">{{cite journal|last1=Ji|first1=Sung-Mi|last2=Kim|first2=Sung-Hoon|last3=Nam|first3=Jae-Sik|last4=Yun|first4=Hye-Joo|last5=Choi|first5=Jeong-Hyun|last6=Lee|first6=Eun-Ho|last7=Choi|first7=In-Cheol|title=Predictive value of rotational thromboelastometry during cardiopulmonary bypass for thrombocytopenia and hypofibrinogenemia after weaning of cardiopulmonary bypass|journal=Korean Journal of Anesthesiology|volume=68|issue=3|year=2015|pages=241|issn=2005-6419|doi=10.4097/kjae.2015.68.3.241}}</ref>
|[[autoimmune lymphoproliferative syndrome type 2]]
| align="center" style="background:#F5F5F5;" + |
|
* [[Platelet]] destruction
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Elderly
| align="center" style="background:#F5F5F5;" + |
* [[Coronary heart disease|Coronary artery disease]]
| align="center" style="background:#F5F5F5;" + |
| align="center" style="background:#F5F5F5;" + |
* [[Purpura]]
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Nl or ↑
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Normocytic normochromic [[erythrocytes]] and markedly reduced [[platelets]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |[[Hematuria case study one|Hematuria]]
| align="center" style="background:#F5F5F5;" + |Clinical manifestation
| align="center" style="background:#F5F5F5;" + |
* [[Coagulopathy]]
* [[Hypofibrinogenemia]]
|-
|-
|
! rowspan="6" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
|[[Factor H|complement factor H deficiency]]
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Alcohol]]<ref name="pmid15100613">{{cite journal |vauthors=Latvala J, Parkkila S, Niemelä O |title=Excess alcohol consumption is common in patients with cytopenia: studies in blood and bone marrow cells |journal=Alcohol. Clin. Exp. Res. |volume=28 |issue=4 |pages=619–24 |date=April 2004 |pmid=15100613 |doi= |url=}}</ref>
|
| align="center" style="background:#F5F5F5;" + |
|
* [[Platelet]] production suppression
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Any
| align="center" style="background:#F5F5F5;" + |
* History of [[Alcoholism|alcohol use]]
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Hepatomegaly]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |[[Cytopenia]], [[macrocytosis]]
| align="center" style="background:#F5F5F5;" + |[[Cytopenia]], [[macrocytosis]]
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Clinical manifestation
| align="center" style="background:#F5F5F5;" + |
* [[Chronic liver disease]]
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Post-transfusion purpura]]<ref name="McCraeHerman1996">{{cite journal|last1=McCrae|first1=Keith R.|last2=Herman|first2=Jay H.|title=Posttransfusion purpura: Two unusual cases and a literature review|journal=American Journal of Hematology|volume=52|issue=3|year=1996|pages=205–211|issn=03618609|doi=10.1002/(SICI)1096-8652(199607)52:3<205::AID-AJH13>3.0.CO;2-E}}</ref><ref name="PavenskiWebert2008">{{cite journal|last1=Pavenski|first1=Katerina|last2=Webert|first2=Kathryn E.|last3=Goldman|first3=Mindy|title=Consequences of transfusion of platelet antibody: a case report and literature review|journal=Transfusion|volume=48|issue=9|year=2008|pages=1981–1989|issn=00411132|doi=10.1111/j.1537-2995.2008.01796.x}}</ref>
|[[Evans syndrome]]
| align="center" style="background:#F5F5F5;" + |
|
* [[Platelet]] destruction by anti-platelet [[antibodies]]
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Women
| align="center" style="background:#F5F5F5;" + |
* History of [[blood transfusion]] or pregnancy
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Purpura]]
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓↓↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Positive circulating alloantibody to a common [[platelet]] antigen
| align="center" style="background:#F5F5F5;" + |
* Severe but rare reaction
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |Gestational thrombocytopenia<ref name="ReesePeck2018">{{cite journal|last1=Reese|first1=Jessica A.|last2=Peck|first2=Jennifer D.|last3=Deschamps|first3=David R.|last4=McIntosh|first4=Jennifer J.|last5=Knudtson|first5=Eric J.|last6=Terrell|first6=Deirdra R.|last7=Vesely|first7=Sara K.|last8=George|first8=James N.|title=Platelet Counts during Pregnancy|journal=New England Journal of Medicine|volume=379|issue=1|year=2018|pages=32–43|issn=0028-4793|doi=10.1056/NEJMoa1802897}}</ref>
|[[immunodysregulation polyendocrinopathy and enteropathy, X-linked]]
| align="center" style="background:#F5F5F5;" + |
|
* Might be physiologic adaptation of pregnancy
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Pregnant women
| align="center" style="background:#F5F5F5;" + |
* Positive history of mild thrombocytopenia
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Diagnosis of exclusion
| align="center" style="background:#F5F5F5;" + |
* Self-limited condition
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" + |[[HELLP syndrome]]<ref name="Barnhart2015">{{cite journal|last1=Barnhart|first1=Lynette|title=HELLP Syndrome and the Effects on the Neonate|journal=Neonatal Network|volume=34|issue=5|year=2015|pages=269–273|issn=07300832|doi=10.1891/0730-0832.34.5.269}}</ref><ref name="HaramSvendsen2009">{{cite journal|last1=Haram|first1=Kjell|last2=Svendsen|first2=Einar|last3=Abildgaard|first3=Ulrich|title=The HELLP syndrome: Clinical issues and management. A Review|journal=BMC Pregnancy and Childbirth|volume=9|issue=1|year=2009|issn=1471-2393|doi=10.1186/1471-2393-9-8}}</ref>
|[[macrophage-activation syndrome]]
| align="center" style="background:#F5F5F5;" + |
|
* Unknown
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + |Pregnant > 25 years
| align="center" style="background:#F5F5F5;" + |
* History of [[Pre-eclampsia|preeclampsia]]
*
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |
* [[Tenderness (medicine)|Abdominal tenderness]]
* [[Ascites]]
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |[[Red blood cell|Schistocytes]]
| align="center" style="background:#F5F5F5;" + |NA
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |[[Proteinuria]]
| align="center" style="background:#F5F5F5;" + |Lab abnormalities
| align="center" style="background:#F5F5F5;" + |
* Elevated [[Liver function tests|liver enzymes]] and [[bilirubin]]
* Multiorgan dysfunction
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" |Idiopathic cyclic thrombocytopenia<ref name="Go2005">{{cite journal|last1=Go|first1=Ronald S.|title=Idiopathic cyclic thrombocytopenia|journal=Blood Reviews|volume=19|issue=1|year=2005|pages=53–59|issn=0268960X|doi=10.1016/j.blre.2004.05.001}}</ref>
|[[neonatal alloimmune thrombocytopenia]]
| align="left" style="background:#F5F5F5;" + |
|
* Unknown
|
* Might be [[Autoimmunity|autoimmune]] platelet destruction
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | +
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | −
|
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |Females with the median age of onset 35 years
| align="left" style="background:#F5F5F5;" + |
* Misdiagnosed as [[Idiopathic thrombocytopenic purpura|ITP]] with uniformly poor responses
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |
* [[Purpura]]
* [[Petechia|Petechiae]]
| align="center" style="background:#F5F5F5;" + |Minor mucocutaneous [[bleeding]]
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + | −
| align="center" style="background:#F5F5F5;" + |↓
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Reduced [[Platelet|platelets]] and [[Megakaryocyte|megakaryocytes]]
| align="center" style="background:#F5F5F5;" + |[[Myelofibrosis|Megakaryocytic]] hypoplasia or aplasia
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Diagnosis of exclusion
| align="left" style="background:#F5F5F5;" + |
* Rebound [[thrombocytosis]]
* [[Myeloproliferative neoplasm|Myeloproliferative diseases]]
* [[Myelodysplastic syndrome]]
|-
|-
|
! colspan="2" align="center" style="background:#DCDCDC;" |Pseudothrombocytopenia<ref name="TanStalling2016">{{cite journal|last1=Tan|first1=Geok Chin|last2=Stalling|first2=Melissa|last3=Dennis|first3=Gretchen|last4=Nunez|first4=Maria|last5=Kahwash|first5=Samir B.|title=Pseudothrombocytopenia due to Platelet Clumping: A Case Report and Brief Review of the Literature|journal=Case Reports in Hematology|volume=2016|year=2016|pages=1–4|issn=2090-6560|doi=10.1155/2016/3036476}}</ref>
|[[systemic lupus erythematosus]]
| align="center" style="background:#F5F5F5;" |
|
* [[Platelet]] clumping due to [[EDTA]]
|
| align="center" style="background:#F5F5F5;" | −
|
| align="center" style="background:#F5F5F5;" | −
|
| align="center" style="background:#F5F5F5;" | −
|
| align="center" style="background:#F5F5F5;" | −
|
| align="center" style="background:#F5F5F5;" | +
|
| align="center" style="background:#F5F5F5;" |Rare
| align="center" style="background:#F5F5F5;" | Collected sample in [[EDTA]] anticoagulant
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | Nl
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" |↓
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" | Low [[platelet]] count and [[platelet]] clumps
| align="center" style="background:#F5F5F5;" | Low [[platelet]] count and [[platelet]] clumps
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |Nl
| align="center" style="background:#F5F5F5;" |Repeat collecting sample in a [[heparin]] tube
| align="center" style="background:#F5F5F5;" | Nl
|-
|-
|'''Miscellaneous'''
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
|
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
|[[Snakebites]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Decreased platelet production
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in blood
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Platelet destruction in spleen
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|}
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Hematology]]
{{WS}}
{{WH}}

Latest revision as of 21:02, 26 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2], Farbod Zahedi Tajrishi, M.D. [2]

Overview

Thrombocytopenia has a broad range of potential causes. While a good history and physical examination can be helpful to diagnose some of these causes such as drug-induced thrombocytopenia, they usually don't suffice and further evaluation is often needed. There are also some useful points that may guide the physician to an appropriate diagnosis. For example, asymptomatic, isolated thrombocytopenia most probably suggests ITP, while thrombocytopenia in critically ill, hospitalized patients is usually suggestive of iatrogenic causes (eg. dilution), platelet consumption, bone marrow suppression from infection/sepsis, or even drug-induced thrombocytopenia. One should consider however, that a wide variety of other conditions such as autoimmune disorders, nutrient deficiencies, thrombotic microangiopathies could all as well cause thrombocytopenia.

Thrombocytopenia Differential Diagnosis

Differentiating the diseases that can cause thrombocytopenia:

Category Condition Etiology Mechanism Inherited Acquried Clinical manifestations Para−clinical findings Gold standard Associated findings
Demography History Symptoms Signs
Lab Findings
Fever Rash Bleeding BP Splenomegaly Jaundice Other CBC PBS Bone marrow exam PT PTT UA
Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Plt HB WBC
Hematology Bone marrow disorders Myelodysplastic syndromes[1]
  • Unknown
  • Mutation
+ ± + Elderly Exposure to + Petechiae, purpura, diffuse erythematous rash + Nl + + Nl Nl Nl Bone marrow examination + clinical manifestation
Aplastic anemia[2] + ± ± Biphasic (the young and the elderly) + Nl Nl Bone marrow examination +

laboratory findings

Acute leukemia[3][4] + + ± ± AML in adults
  • Exposure to chemicals
  • Radiation
  • Pre-existent blood disorders
± Petechiae + Nl ±
  • Blast cells
Bone marrow examination
Paroxysmal nocturnal hemoglobinuria (PNH)[5]
  • Mutations
+ + + Any age

(usually younger adults)

Nl ↓/Nl ↓/Nl
  • Hypocellular marrow in certain stages of the disease
Nl Nl Flow cytometry
Condition Etiology Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Inherited Acquried Demography History Fever Rash Bleeding BP Splenomegaly Jaundice Other signs Plt HB WBC PBS Bone marrow exam PT PTT UA Gold standard Associated findings
Thrombotic microangiopathy (TMA) Thrombotic thrombocytopenic purpura (TTP)[6]
  • Deficiency of, or antibodies to, the metalloprotease ADAMTS13  
+ ± + Any age
  • Neurologic manifestations
  • Fatigue due to anemia
+ Petechiae Not common Nl or ↑ + Nl

or ↑

  • Fragmented RBCs
NA Nl Nl Laboratory findings
Hemolytic uremic syndrome (HUS)[7] + ± + Children
  • Exposure to contaminated water or milk
  • Consuming undercooked ground beef
+ Petechiae + Nl

or ↑

  • Fragmented RBCs
NA Nl Nl Laboratory findings
DIC[8][9]
  • Overstimulation of the coagulation system
+ + + Any age + + + + ↓↓ ↑↑ Clinical manifestation + laboratory findings
Nutrient deficiencies Folate, vitamin B12, copper deficiencies[10][11]
  • Decreased platelet production
+ + Any age
  • Malnutrition
  • Alcohol use
Nl Nl Nl Nl Nl Laboratory findings
Condition Etiology Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Inherited Acquried Demography History Fever Rash Bleeding BP Splenomegaly Jaundice Other signs Plt HB WBC PBS Bone marrow exam PT PTT UA Gold standard Associated findings
Congenital platelet disorders[12][13][14] MYH9-related disorders[15] + + Any age, very rare
  • Positive family history
+ Nl Nl
  • Döhle body-like inclusions in peripheral blood neutrophils
NA Nl Nl Nl Genetic study
Bernard-Soulier syndrome[16]
  • Absence of Gp Ib-IX-V  
+ + Children, rare
  • Positive family history
+ Nl Nl Nl Nl Nl Nl Flow cytometry
Gray platelet syndrome[17] + + Rare
  • Positive family history
+

Mucocutaneous

Nl + Nl Nl Nl Nl Nl Genetic study
Wiskott-Aldrich syndrome[18] + + Rare
  • Positive family history
+ Nl Bloody diarrhea Nl Nl Nl Nl Nl Genetic study
Thrombocytopenia with absent radius (TAR) syndrome[19] + + Children
  • Positive family history
+ + Nl Nl Nl or ↑ Nl Nl Nl Evidence of absent radius

+

Laboratory findings

  • Cow's milk allergy
  • Various other anomalies
Fechtner syndrome[20]
  • Mutation of chromosome 22q11-13
+ + Children
  • Positive family history

petechia

+ Mucocutaneous Nl
  • Hearing loss
  • Eye abnormalities
Nl Nl or ↑ NA Nl Nl Clinical manifestation + genetic study
Von Willebrand disease[21]
  • VWF deficiency/dysfunction
+ + Rarely More common with O blood type
  • Positive family history
+ Nl/ ↓ Nl/↓ Nl NA Nl Nl or ↑ Laboratory findings
  • Lifelong bleeding disorder
Category Condition Etiology Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Inherited Acquried Demography History Fever Rash Bleeding BP Splenomegaly Jaundice Other signs Plt HB WBC PBS Bone marrow exam PT PTT UA Gold standard Associated findings
Rheumatologic/autoimmune disorders ITP[22] + + + Any age

petechia

+ Mucocutaneous Nl ↓↓↓ Nl Nl Nl Nl Nl Nl Diagnosis of exclusion
  • Spontaneous remission  
Systemic lupus erythematosus[23] + + Young women, more prevalent in Africans and Asians + Malar rash, generalized maculopapular rash, discoid rash +

Hemoptysis

Nl or ↑ + + Clinical manifestation + serology
Antiphospholipid syndrome[24]
  • Autoantibody-mediated syndrome
+ + + Middle aged women, more in African American and Hispanic population Nl Nl Nl Clinical manifestation + repeated positive tests of aPL
Felty's syndrome[25] + + ± + Rare, young women Nl +
  • Lymphadenopathy
Nl Nl Nl Nl Clinical manifestation
Category Condition Etiology Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Inherited Acquried Demography History Fever Rash Bleeding BP Splenomegaly Jaundice Other signs Plt HB WBC PBS Bone marrow exam PT PTT UA Gold standard Associated findings
Infection-induced Bacterial infections Sepsis[26] + + + Any + ± Nl to ↓ ± ↓/↑ Nl ↑↑ NA +

Depends on the etiology

Clinical manifestation + culture
  • Associated with ↑ mortality
Helicobacter pylori[27]
  • Immune thrombocytopenia
+ + Any Nl Nl Nl NA Nl Nl Nl Clinical manifestation + culture
Tick-borne infection[28]
  • Immune thrombocytopenia
+ + Endemic area like China, Japan, and Korea
  • Being bitten by a tick
+ ± Nl to ↓ ± ± Nl NA Nl Nl PCR
Viral infections HIV[29]
  • Immune thrombocytopenia
+ + + + Any
  • High risk behaviors
  • Close contact
+ ± Nl to ↓ ± ± Isolation of HIV
Other viruses such as rubella, mumps, varicella, parvovirus, hepatitis C, & Epstein-Barr virus[30]
  • Immune thrombocytopenia
+ + Any
  • High risk behaviors
  • Close contact
+ Nl ± ± Nl Nl Clinical manifestation + lab tests
Parasitic infections Malaria[31]
  • Unknown
  • Immune thrombocytopenia
+ + Endemic area
  • Being bitten by a mosquito
+ ± Nl to ↓ ± ± Nl Nl Clinical manifestation + microscopic examination of blood smear
Babesiosis[32]
  • Unknown
  • Immune thrombocytopenia
+ + Rare + ± Nl to ↓ ± ± Nl Nl Clinical manifestation + microscopic examination of blood smear
Category Condition Etiology Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Inherited Acquried Demography History Fever Rash Bleeding BP Splenomegaly Jaundice Other signs Plt HB WBC PBS Bone marrow exam PT PTT UA Gold standard Associated findings
Medication/toxicity Antibiotics/

Antiepileptic[33]

  • Occurrence of drug-dependent, platelet-reactive antibodies
+ + + Any
  • Drug ingestion or injection
Nl ↓↓ Nl NA Nl Nl Nl Clinical manifestation + exclusion of the other causes NA
Heparin-induced thrombocytopenia[34]
  • Anti-heparin/PF4 antibody 
+ + Any
  • Heparin injection
  • Necrotic skin lesions
Nl Nl Nl NA Nl Nl Nl ELISA
Cytotoxic chemotherapy[35] + + Patients with malignancy
  • Drug ingestion or injection
  • Cancer
Nl
  • Megakaryocytic hypoplasia or aplasia
Hematuria Clinical manifestation + exclusion of the other causes
Radiation therapy[36] + + Patients with malignancy + Nl
  • Megakaryocytic hypoplasia or aplasia
Hematuria Clinical manifestation + exclusion of the other causes
GI Chronic liver disease[37] + + Any + + + Nl NA Nl Biopsy
Portal hypertension[38] + + Any + + + Nl NA Nl Clinical manifestation
Category Condition Etiology Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Inherited Acquried Demography History Fever Rash Bleeding BP Splenomegaly Jaundice Other signs Plt HB WBC PBS Bone marrow exam PT PTT UA Gold standard Associated findings
Vascular Giant capillary hemangioma (Kasabach-Merritt syndrome)[39][40] + + Infants Intralesional bleeding Nl Visceral hemangiomas ↓↓ ↓↓ Nl Normocytic normochromic erythrocytes and markedly reduced platelets Normal erythropoiesis, myelopoiesis, and megakaryocytic hyperplasia Hematuria Biopsy
  • Kaposiform hemangioendothelioma
  • Tufted angioma
Cardiopulmonary bypass[41] + + Elderly + Nl or ↑ Nl Normocytic normochromic erythrocytes and markedly reduced platelets NA Hematuria Clinical manifestation
Other Alcohol[42] + + + Any Nl + + Cytopenia, macrocytosis Cytopenia, macrocytosis Nl Clinical manifestation
Post-transfusion purpura[43][44] + + Women + ↓↓↓ Nl Nl NA Nl Nl Nl Positive circulating alloantibody to a common platelet antigen
  • Severe but rare reaction
Gestational thrombocytopenia[45]
  • Might be physiologic adaptation of pregnancy
+ Pregnant women
  • Positive history of mild thrombocytopenia
Nl Nl Nl Nl NA Nl Nl Nl Diagnosis of exclusion
  • Self-limited condition
HELLP syndrome[46][47]
  • Unknown
+ + Pregnant > 25 years + + Nl Schistocytes NA Nl Nl Proteinuria Lab abnormalities
Idiopathic cyclic thrombocytopenia[48] + + + Females with the median age of onset 35 years
  • Misdiagnosed as ITP with uniformly poor responses
Minor mucocutaneous bleeding Nl Nl Nl Reduced platelets and megakaryocytes Megakaryocytic hypoplasia or aplasia Nl Nl Nl Diagnosis of exclusion
Pseudothrombocytopenia[49] + Rare Collected sample in EDTA anticoagulant Nl Nl Nl Low platelet count and platelet clumps Low platelet count and platelet clumps Nl Nl Nl Repeat collecting sample in a heparin tube Nl
Category Condition Etiology Decreased platelet production Platelet destruction in blood Platelet destruction in spleen Inherited Acquried Demography History Fever Rash Bleeding BP Splenomegaly Jaundice Other signs Plt HB WBC PBS Bone marrow exam PT PTT UA Gold standard Associated findings

References

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