Materiały źródłowe

• #1 Thrombocytopenia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542208/

  Thrombocytopenia is a platelet count below the lower limit of normal, i.e., 150000/microliter (for adults). This activity reviews the etiology, evaluation, and management of thrombocytopenia and highlights the role of the interprofessional team in improving care for patients with this condition. […] Common causes of thrombocytopenia: Primary immune thrombocytopenia (primary ITP). An autoimmune condition where antibodies are produced against platelets resulting in platelet destruction. […] Drug-induced immune thrombocytopenia: Heparin-induced thrombocytopenia (HIT) – in this condition, anti-platelet antibodies activate platelets resulting in thrombosis (both arterial and venous). […] Infections: Viral: HIV, hepatitis C, Ebstein-Barr virus, parvovirus, mumps, varicella, rubella, Zika viral infections can cause thrombocytopenia.

• #2 Thrombocytopenia (low platelet count) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thrombocytopenia/symptoms-causes/syc-20378293

  Thrombocytopenia might occur as a result of a bone marrow disorder such as leukemia or an immune system problem. Or it can be a side effect of taking certain medications. […] Thrombocytopenia rarely is inherited; or it can be caused by a number of medications or conditions. Whatever the cause, circulating platelets are reduced by one or more of the following processes: trapping of platelets in the spleen, decreased platelet production or increased destruction of platelets. […] Factors that can decrease platelet production include: leukemia and other cancers, some types of anemia, viral infections, such as hepatitis C or HIV, chemotherapy drugs and radiation therapy, heavy alcohol consumption. […] Some conditions can cause your body to use up or destroy platelets faster than they’re produced, leading to a shortage of platelets in your bloodstream. Examples of such conditions include: pregnancy, immune thrombocytopenia, bacteria in the blood, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, medications.

• #3 Thrombocytopenia: Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/14430-thrombocytopenia

  Thrombocytopenia occurs when your bone marrow doesnt make enough platelets. Thrombocytopenia often affects people with certain medical conditions, like autoimmune disease or who take certain medications. […] Thrombocytopenia causes fall into one of three categories: Your bone marrow doesnt make enough platelets. This may happen if you have blood cancers like leukemia or lymphoma. Your bone marrow makes enough platelets, but your platelet supply runs low because you have conditions that use up your platelet supply or destroy your platelets. Your spleen traps platelets so they cant circulate through your bloodstream. […] Specific factors affecting platelet supply include: Autoimmune diseases, like immune thrombocytopenia (ITP), lupus and rheumatoid arthritis, that attack your immune system may destroy platelets. Blood cancers, leukemia and lymphoma may damage your bone marrow and affect its ability to make enough blood cells, including platelets. Cancer treatments, including chemotherapy and radiation therapy sometimes destroy stem cells that would have become platelets. Thrombotic thrombocytopenic purpura (TPP) causes blood clots in small blood vessels throughout your body. Platelets make blood clots. Your platelet supply may run low if you have TPP or a similar condition, disseminated intravascular coagulation, which uses up platelets. Infections, bacterial and viral infections may lower your platelet levels. Alcohol use disorder slows platelet production. Drinking a lot of alcohol may cause your platelet level to drop. Toxic chemicals, exposure to toxic chemicals, including arsenic, benzene and pesticides, may affect your platelet level. Medications, antibiotics that treat bacterial infections, medication for seizures and heart conditions, and the blood thinner heparin may affect platelet levels.

• #4 Thrombocytopenia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/thrombocytopenia

  Thrombocytopenia has different causes. Sometimes, the bone marrow isnt producing enough platelets, or the platelets are being removed from the bloodstream by the immune system, spleen, or liver. Determining the cause of thrombocytopenia helps doctors determine how to treat the condition. […] Thrombocytopenia can occur because the bone marrow doesnt produce enough platelets, and there are different reasons for this. Certain medications, chemotherapy (medication to treat cancer), radiation therapy, infections, poor nutrition, or inherited genetic conditions can cause the bone marrow to stop making platelets. Certain cancers can also arise in the marrow, such as leukemia (a cancer of the white blood cells), or cancers can infiltrate into the marrow, such as solid tumors (metastases), which cause the marrow to stop making platelets. Certain metabolic disorders can also cause abnormal proteins or fats to infiltrate into the marrow causing it to stop making platelets.

• #5 Thrombocytopenia Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/thrombocytopenia

  Thrombocytopenia is often divided into 3 major causes of low platelets: […] Not enough platelets are made in the bone marrow […] Increased removal of platelets in the bloodstream […] Increased trapping of platelets in the spleen or liver. Your bone marrow may not make enough platelets if you have any of the following conditions: […] Aplastic anemia (disorder in which the bone marrow does not make enough blood cells) […] Cancer in the bone marrow, such as leukemia […] Cirrhosis (liver scarring) […] Folate deficiency […] Infections in the bone marrow (very rare) […] Myelodysplastic syndrome (bone marrow does not make enough blood cells or makes defective cells) […] Vitamin B12 deficiency. Use of certain medicines may also lead to a low production of platelets in the bone marrow. The most common example is chemotherapy treatment for cancer. The following health situations cause a low number of platelets:

• #5 Thrombocytopenia Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/thrombocytopenia

  Disorder in which the proteins that control blood clotting become over active, most often during a serious illness (disseminated intravascular coagulation – DIC) […] Drug-induced low platelet count […] Enlarged spleen […] Disorder in which the immune system destroys platelets (immune thrombocytopenic purpura – ITP) […] Disorder that causes blood clots to form in small blood vessels, causing a low platelet count (thrombotic thrombocytopenic purpura – TTP).

• #6 Thrombocytopenia: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000586.htm

  Thrombocytopenia is often divided into 3 major causes of low platelets: […] Not enough platelets are made in the bone marrow […] Increased removal of platelets in the bloodstream […] Increased trapping of platelets in the spleen or liver. […] Your bone marrow may not make enough platelets if you have any of the following conditions: Aplastic anemia (disorder in which the bone marrow does not make enough blood cells) […] Cancer in the bone marrow, such as leukemia […] Cirrhosis (liver scarring) […] Folate deficiency […] Infections in the bone marrow (very rare) […] Myelodysplastic syndrome (bone marrow does not make enough blood cells or makes defective cells) […] Vitamin B12 deficiency. […] Use of certain medicines may also lead to a low production of platelets in the bone marrow. The most common example is chemotherapy treatment for cancer.

• #7 Thrombocytopenia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/thrombocytopenia/

  Liver disease and chronic alcohol abuse (decreased production of thrombopoietin in the liver). […] Splenomegaly. […] Gestational thrombocytopenia. […] Thrombocytopenia following transfusion or fluid resuscitation. […] Mechanical damage due to artificial cardiac valves or extracorporeal circulation (e.g., dialysis).

• #7 Thrombocytopenia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/thrombocytopenia/

  Congenital thrombocytopenias: Wiskott-Aldrich syndrome, Alport syndrome, Bernard-Soulier syndrome, Fanconi anemia, von Willebrand disease. […] Infection: CMV, EBV, hepatitis C virus, HIV, mumps and rubella, parvovirus B19, rickettsia, VZV, dengue. […] Malignancy: leukemia, lymphoma, bone marrow infiltration, myelodysplastic syndrome. […] Immune thrombocytopenia; (ITP) and other autoimmune diseases (e.g., systemic lupus erythematosus, rheumatoid arthritis). […] Disseminated intravascular coagulation (DIC) and sepsis. […] Thrombotic thrombocytopenic purpura; (TTP) and hemolytic uremic syndrome (HUS). […] Drug-induced immune thrombocytopenia (DITP): Platelet-activating antibodies cause a hypercoagulable state and simultaneous reduction in platelet count. […] Pregnancy: preeclampsia; and HELLP syndrome.

• #7 Thrombocytopenia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/thrombocytopenia/

  Thrombocytopenia is a platelet count below the normal range that is most commonly due to either impaired platelet production in the bone marrow or increased platelet turnover in the periphery. Common causes of impaired platelet production include bone marrow failure, infection, malignancy, and chemotherapy/radiation. Additional etiologies include hereditary syndromes, such as Wiskott-Aldrich syndrome and Alport syndrome. […] In contrast, increased peripheral platelet turnover may be caused by autoimmune conditions, (e.g., immune thrombocytopenia), drugs (e.g., heparin), and other conditions (e.g., TTP/HUS, DIC/sepsis). […] Bone marrow failure: aplastic anemia, paroxysmal nocturnal hemoglobinuria. […] Bone marrow suppression: drugs (e.g., linezolid, daptomycin, valproic acid, valacyclovir), chemotherapy, radiation.

• #8 Platelet Disorders – Thrombocytopenia | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/thrombocytopenia

  Alcohol slows the production of platelets. Drinking too much alcohol can cause your platelet count to drop for a short time. This is more common in people who have low levels of vitamin B12, or folate. […] Some medicines can slow the production of platelets. Also, a reaction to medicine can confuse your body and cause it to destroy its platelets. […] Examples of health problems that can reduce your platelet count are listed below. […] Aplastic anemia is a rare, serious blood disorder that develops when the bone marrow stops making enough new blood cells. […] Autoimmune diseases, such as immune thrombocytopenia (ITP), lupus, and rheumatoid arthritis can cause your immune system to attack and destroy your platelets by mistake. […] Cancer, such as leukemia or lymphoma, can damage your bone marrow and destroy blood stem cells.

• #8 Platelet Disorders – Thrombocytopenia | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/thrombocytopenia

  Thrombocytopenia can be inherited or acquired. Inherited means your parents pass the gene for the condition to you. Acquired means you are not born with the condition, but you develop it later. Sometimes the cause of thrombocytopenia is not known. […] You may have a low platelet count for the following reasons. […] Your body’s bone marrow does not make enough platelets. […] Your bone marrow makes enough platelets, but your body destroys them or uses them up. […] Your spleen holds on to too many platelets. The spleen is an organ in your abdomen. It normally stores about one-third of the body’s platelets. It also helps your body fight infection. […] The following factors can raise your risk of thrombocytopenia. […] Exposure to toxic chemicals such as pesticides, arsenic, and benzene can slow the production of platelets.

• #8 Platelet Disorders – Thrombocytopenia | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/thrombocytopenia

  Conditions that cause blood clots, such as thrombotic thrombocytopenic purpura (TTP) and disseminated intravascular coagulation (DIC), can cause your body to use up all your platelets. This leads to a low platelet count. […] Infections from bacteria and viruses can lower your platelet count for a while. […] A spleen that is larger than normal may remove or store too many platelets, and you may not have enough platelets in your blood. […] Some pregnant women develop mild thrombocytopenia when they are close to delivery. The exact cause is not known. […] Platelets can be destroyed when they pass through artificial heart valves, blood vessel grafts, or machines and tubing used for blood transfusions or bypass surgery.

• #9 Thrombocytopenia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/thrombocytopenia

  Some medications or chemicals that can cause thrombocytopenia include: Chemotherapy for cancer; Radiation therapy for cancer; Drugs, such as cyclosporine, that suppress the immune system after organ transplantation; Some diuretics, like furosemide; Blood thinners, including heparin; H2 blockers (which work by reducing the amount of acid produced and secreted by cells in the lining of the stomach) for acid reflux, including ranitidine and cimetidine; Some antibiotics, including penicillin and ampicillin; Sulfonamides; Certain anti-seizure medications, including valproic acid; Certain vaccines, including measles-mumps-rubella (MMR) and COVID-19; Some statins, which lower cholesterol; Nonsteroidal anti-inflammatory drugs (NSAIDs); Gold salts for arthritis; Quinine for malaria; Smoking tobacco.

• #9 Thrombocytopenia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/thrombocytopenia

  Thrombocytopenia can also occur because platelets are being removed from the bloodstream by the immune system, spleen, or liver. Common causes include infections, medications, an autoimmune disease, inherited or acquired bleeding disorders, an enlarged spleen for any reason, liver disease, or an inherited immune deficiency or disorder. […] Thrombocytopenia is often caused by medical conditions or certain medications. A family history of the condition may also be a factor. […] Some of the medical conditions that are associated with thrombocytopenia include: Bone marrow disorders, such as aplastic anemia or myelodysplastic syndrome; Leukemia or other bone marrow cancer; An infection of the bone marrow; A viral infection; Liver cirrhosis; Hepatitis C; HIV; Bacterial sepsis; Lupus, scleroderma, or other autoimmune diseases; Pregnancy; Folate deficiency; Vitamin B12 or other nutrient deficiencies; Alcohol use disorder; An enlarged spleen; Gaucher disease and other metabolic disorders; Disseminated intravascular coagulation (DIC), a blood clotting disorder; Metastatic cancer; COVID-19.

• #10 Thrombocytopenia: Other Causes – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/thrombocytopenia-and-platelet-dysfunction/thrombocytopenia-other-causes

  Commonly used medications that occasionally induce thrombocytopenia include Carbamazepine, Chlorpropamide, Glycoprotein IIb/IIIa inhibitors (eg, abciximab, eptifibatide, tirofiban), Heparin, Hydrochlorothiazide, Quinine, Ranitidine, Rifampin, Trimethoprim/sulfamethoxazole, Vancomycin. […] Heparin-induced thrombocytopenia (HIT) occurs in up to 1% of patients receiving unfractionated heparin. […] HIV infection may cause immunologic thrombocytopenia indistinguishable from immune thrombocytopenia except for the association with HIV. […] Hepatitis C infection is commonly associated with thrombocytopenia. […] Other infections, such as systemic viral infections (eg, Epstein-Barr virus, cytomegalovirus), rickettsial infections (eg, Rocky Mountain spotted fever), and bacterial sepsis, often accompany thrombocytopenia.

• #10 Thrombocytopenia: Other Causes – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/thrombocytopenia-and-platelet-dysfunction/thrombocytopenia-other-causes

  Platelet destruction can develop because of immunologic causes (viral infection, medications, systemic rheumatic or lymphoproliferative disorders, blood transfusions) or nonimmunologic causes (sepsis, vascular malformations, acute respiratory distress syndrome). […] Patients with acute respiratory distress syndrome may develop nonimmunologic thrombocytopenia, possibly secondary to deposition of platelets in the pulmonary capillary bed. […] Posttransfusion purpura involves immunologic platelet destruction indistinguishable from immune thrombocytopenia (ITP), except for a history of a blood transfusion within the preceding 7 to 10 days. […] Systemic rheumatic disorders (eg, systemic lupus erythematosus, antiphospholipid syndrome) or lymphoproliferative disorders (eg, chronic lymphocytic leukemia [CLL]) can cause secondary ITP.

• #10 Thrombocytopenia: Other Causes – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/thrombocytopenia-and-platelet-dysfunction/thrombocytopenia-other-causes

  Thrombocytopenia, typically asymptomatic, occurs late in gestation in about 5% of normal pregnancies (gestational thrombocytopenia); it is usually mild (platelet counts 70,000/mcL [ 70 109/L] are rare), requires no treatment, and resolves after delivery. […] Sepsis often causes nonimmunologic thrombocytopenia that parallels the severity of the infection.

• #11 Thrombocytopenia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542208/

  Autoimmune disorders like systemic lupus erythematosus, rheumatoid arthritis associated with secondary ITP. […] Pregnancy. Mild thrombocytopenia presents in gestational thrombocytopenia; moderate-severe thrombocytopenia can occur in preeclampsia and HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome. […] Other causes: Myelodysplasia, Malignancy: cancer with chronic DIC, cancer with marrow suppression (leukemia, lymphoma, solid tumors), Paroxysmal nocturnal hemoglobinuria (PNH), Thrombotic microangiopathy (TMA). […] In immune-mediated thrombocytopenia, anti-platelet autoantibodies bind to platelets and megakaryocytes, resulting in increased platelet destruction by the reticuloendothelial system and decreased platelet production. […] Non-immune mediated increased platelet destruction occurs in mechanical valve replacement patients, preeclampsia/HELLP syndrome, DIC, and thrombotic microangiopathy.

• #12 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/202158-overview

  Immune thrombocytopenia (ITP) is a syndrome in which platelets become coated with autoantibodies to platelet membrane antigens, resulting in splenic sequestration and phagocytosis by mononuclear macrophages. […] The term „idiopathic” no longer applies, because the etiology is known: ITP is caused by a dysregulation of the immune system. […] In children, most cases of immune thrombocytopenia (ITP) are acute, manifesting a few weeks after a viral illness. In adults, most cases of ITP are chronic, manifesting with an insidious onset, and occur in middle-aged women. These clinical presentations suggest that the triggering events may be different. However, in both children and adults, the cause of thrombocytopenia (destruction of antibody-coated platelets by mononuclear macrophages) appears to be similar.

• #12 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/202158-overview

  In chronic ITP, for unknown reasons, membrane glycoproteins (GPs) on the surface of platelets become immunogenic, stimulating the production of platelet autoantibodies. In acute ITP, the stimulus for autoantibody production is also unknown; platelet membrane cryptantigens may become exposed by the stress of infection, or pseudoantigens may be formed by the passive adsorption of pathogens on platelet surfaces. […] The spleen is the site of autoantibody production (white pulp); it is also the site of phagocytosis of autoantibody-coated platelets (red pulp). The slow passage of platelets through splenic sinusoids with a high local concentration of antibodies and Fc-gamma receptors on splenic macrophages lend to the uniqueness of the spleen as a site of platelet destruction. […] The mononuclear macrophage system of the spleen is responsible for removing platelets in ITP, as demonstrated by the fact that splenectomy results in prompt restoration of normal platelet counts in most patients with ITP.

• #13 Incidentally detected thrombocytopaenia in adults

  https://www.racgp.org.au/afp/2014/october/incidentally-detected-thrombocytopaenia-in-adults

  There is an association between systemic autoimmune disorders such as systemic lupus erythematosus (SLE) and the antiphospholipid syndrome and thrombocytopenia. […] ITP is an immune disorder characterised by isolated thrombocytopenia and is strictly a diagnosis of exclusion. The incidence is estimated at approximately 1.6-3.9 per 100,000 person years. It is caused by increased platelet clearance and decreased production, but the details of how these develop are complex and for the most part remain undetermined. […] Thrombotic thrombocytopenic purpura (TTP) and haemolytic uraemic syndrome (HUS) are multi-system disorders characterised by thrombocytopenia and microangiopathic haemolytic anaemia. TTP and HUS are life-threatening illnesses; TTP has a mortality rate of 90% without appropriate treatment.

• #13 Incidentally detected thrombocytopaenia in adults

  https://www.racgp.org.au/afp/2014/october/incidentally-detected-thrombocytopaenia-in-adults

  With the advent of automated counters, low platelet counts are a common incidental finding. The list of possible aetiologies is long and exhaustive. Platelet abnormalities range from having no clinical relevance to being the only initial manifestation of a serious underlying disorder. […] There are no specific laboratory tests that can conclusively identify the mechanism of thrombocytopenia; a thorough history, clinical examination, and blood results remain the initial means of diagnosis. […] Thrombocytopenia may be seen in up to 76% of patients with chronic liver disease. If there is clinical suspicion of high alcohol use, hepatitis, intrinsic liver disease or obstruction, clinical assessment for stigmata of CLD followed by formal liver function tests are warranted. […] About 20% of patients with megaloblastic anaemia due to vitamin B12 and folic acid deficiency also have thrombocytopenia. These deficiencies should be suspected in patients with excess alcohol use or malnourishment, and the elderly with poor oral intake.

• #14 What causes a low platelet count (Thrombocytopenia)?

  https://www.medicalnewstoday.com/articles/314123

  Various substances can cause a person to have a low platelet count, including medications, poisonous substances, heavy alcohol consumption, and quinine. […] Prescription medications that can cause thrombocytopenia include amiodarone, ampicillin and other antibiotics, cimetidine, glycoprotein IIb/IIIa inhibitors, heparin, piperacillin, seizure medications, sulfonamides, and vancomycin. […] Causes of a low platelet count include medical conditions and exposure to certain medications and substances, such as alcohol and quinine.

• #15 Immune thrombocytopenia (ITP) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/symptoms-causes/syc-20352325

  Immune thrombocytopenia usually happens when the immune system makes a mistake. It attacks and destroys the cells that help blood clot, also known as platelets. […] In adults, an infection with HIV, hepatitis or the bacteria that causes stomach ulcers, known as H. pylori, can cause ITP. In most children with ITP, the disorder follows a virus, such as the mumps or the flu.

• #16 Thrombocytopenia in Adults: Review Article | Erkurt | Journal of Hematology

  https://thejh.org/index.php/jh/article/view/28/20

  Myelodysplastic syndrome (MDS) is characterized proliferation of myeloblastic leukemia cell and with the deficiency of bone marrow is a heterogeneous clonal group of hematology disease. […] Paroxysmal nocturnal hemoglobinuria (PNH), is a rare, acquired, clonal, potentially life-threatening disease of the blood characterised by complement-induced intravascular hemolysis, cytopenia, red urine and thrombosis. […] It is regarded as a presentation of immune thrombocytopenia that are not mutad with the reason of it is not known. […] Posttransfusion Purpura (PTP) is very rare but severe complication of blood transfusion, characterised by the sudden onset of severe thrombocytopenia within 5 – 10 days of transfusion of blood products. […] With the increasing incidence of cancer, chemotherapy has become a common cause of thrombocytopenia.

• #16 Thrombocytopenia in Adults: Review Article | Erkurt | Journal of Hematology

  https://thejh.org/index.php/jh/article/view/28/20

  Thrombocytopenia was seen in 20% of patients with megaloblastic anemia due to vitamin B12 and folic acid deficiency. […] Asymptomatic thrombocytopenia can be seen 5% in normal pregnancy. […] Aplastic anemia is a deficiency of stem cell which consist pancytopenia and aplasia in bone marrow. […] Thrombocytopenia which is seen in hypersplenism is usually middle degree and clinical importance is developed after coagulation disorders. […] Thrombotic Thrombocytopenic Purpura (TTP) is a syndrome which is consist of little veins with widespreading thrombotic occlusion characterized microangiopatic hemolytic anemia, thrombocytopenia, neurological symptoms, fever and disorders of kidney. […] Hellp syndrome which is characterized hemolysis, increasing the liver enzyme and thrombocytopenia is pregnancy complication.

• #16 Thrombocytopenia in Adults: Review Article | Erkurt | Journal of Hematology

  https://thejh.org/index.php/jh/article/view/28/20

  Thrombocytopenia which depends on deficiency of producing myelosupressive drugs, radiation and as aplastic anemia can be seen due to suppression of megakaryocyte in bone marrow. […] Immune thrombocytopenia is an autoimmun illness which is developed against platelets auto antibodies and owing to destruction of premature platelets. […] The number of platelet in ITP is under the level 150,000/microL. […] The lifetime of platelet cut down. […] Although most of ITP are autoimmune especially viral infection starts this. […] The most important laboratory finding is thrombocytopenia and platelet anisocytosis. […] The reasons of thrombocytopenia is at chronic liver illness secondary to portal hypertension splenomegaly, as immunology demolishing of platelets and the third one is lessening of production thrombopoetin.

• #16 Thrombocytopenia in Adults: Review Article | Erkurt | Journal of Hematology

  https://thejh.org/index.php/jh/article/view/28/20

  Thrombocytopenia is the result of falling the number of platelet from 150,000/microL. There are three main reasons of thrombocytopenia, a-Decreasing of making platelet b-Increasing of destruction platelet c-Changing of distribution platelet. […] Both hereditary and acquired reasons help thrombocytopenia have wide spreaded, but acquired causes are more common with increasing age. […] The reason of thrombocytopenia can be temporary but also can be caused severe diseases. […] Causes of thrombocytopenia change development levels of countries, according to geographical distribution and application centers. […] In this review we emphasize common etiologies seen in adult patients with thrombocytopenia. […] There are three major patophsiological mechanisms in thrombocytopenia: reduced producing, rapid demolishing and sequestration. Rapid demolishing is the reason thrombocytopenia which is often seen.

• #17 Overview of Thrombocytopenia – Blood Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/blood-disorders/platelet-disorders/overview-of-thrombocytopenia

  Thrombocytopenia occurs when the bone marrow makes too few platelets or when too many platelets are destroyed or accumulate within an enlarged spleen. […] Many disorders can cause thrombocytopenia, but these disorders fall into 3 main categories: Too few platelets are produced, Too many platelets are destroyed, Too many platelets are trapped in the spleen. […] Thrombocytopenia can occur when the bone marrow does not produce enough platelets, as happens in leukemia or other bone marrow disorders. […] Infection with hepatitis C virus, the human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]), Epstein-Barr virus (the usual cause of mononucleosis), and many other viruses may result in thrombocytopenia. […] Platelets can become entrapped in an enlarged spleen, as happens in cirrhosis of the liver, myelofibrosis, and Gaucher disease, reducing the number of platelets in the bloodstream.

• #17 Overview of Thrombocytopenia – Blood Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/blood-disorders/platelet-disorders/overview-of-thrombocytopenia

  Finally, the body may use or destroy too many platelets, as occurs in many disorders. Three of the most notable of these disorders are immune thrombocytopenia, thrombotic thrombocytopenic purpura, and hemolytic-uremic syndrome. […] Some medications and drugs such as heparin, certain antibiotics, ethanol, anticancer drugs, and quinine can also cause thrombocytopenia. Drug-induced thrombocytopenia may be the result of Decreased platelet production by the bone marrow (caused by bone marrow toxicity) and Increased platelet destruction (immune-mediated thrombocytopenia).

• #18 Thrombocytopenia and Platelet Function Disorders | Doctor

  https://patient.info/doctor/thrombocytopenia-and-platelet-function-disorders

  Drug-induced – eg, heparin, carbamazepine, ibuprofen, quinidine, quinine, rifampin, sulfamethoxazole, trimethoprim and vancomycin. […] Pregnancy – mild thrombocytopenia can occur in normal pregnancy; moderate-severe thrombocytopenia occurs in HELLP syndrome, characterised by: H(aemolysis), EL(elevated liver) enzymes, LP(low platelet) count. […] This is caused by transfusion of large volumes of blood which may be depleted of functioning platelets, resulting from prolonged storage. […] Inherited platelet function disorders (where the number of platelets may be normal or lower than normal): Severe disorders of platelet function: WAS, Glanzmann’s thrombasthenia (GT), BSS. […] Acquired platelet function disorders: Medications and chemicals – eg, aspirin, other non-steroidal anti-inflammatory drugs (NSAIDs), clopidogrel, dipyridamole, beta-lactam antibiotics, dextran, alcohol. […] Antibody-induced platelet dysfunction: bleeding in patients with ITP usually occurs at very low platelet counts. Occasionally, patients will have bleeding symptoms with only mild-to-moderate thrombocytopenia.

• #19 Thrombocytopenia | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0315/p612.html

  Common etiologies with clinical findings and suggested treatment are listed in Table 2,714 and clinical considerations to aid in diagnosis are listed in Table 3. […] Chronic alcohol abuse, congenital syndromes, ITP, liver disease, myelodysplastic syndrome. […] Drug-induced thrombocytopenia should be suspected in all patients presenting with an acute drop in platelet count. […] Most patients with drug-induced thrombocytopenia have moderate to severe thrombocytopenia reaching a nadir platelet count of 20 103 per L. […] Infections may cause thrombocytopenia by direct bone marrow suppression or increased peripheral platelet consumption. […] Chronic liver disease usually causes persistent thrombocytopenia, and manifests as cirrhosis, fibrosis, and portal hypertension. […] Gestational thrombocytopenia is the most common diagnosis of thrombocytopenia in pregnancy, occurring in 8 percent of pregnancies. […] Its etiology is thought to be hemodilution and accelerated platelet clearance.

• #19 Thrombocytopenia | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0315/p612.html

  Thrombocytopenia is defined as a platelet count of less than 150 103 per L. […] The etiology usually is not obvious, and additional investigation is required. […] Patients who present with thrombocytopenia as part of a multisystem disorder usually are ill and require urgent evaluation and treatment. These patients most likely have an acute infection, heparin-induced thrombocytopenia, liver disease, thrombotic thrombocytopenic purpura/hemolytic uremic syndrome, disseminated intravascular coagulation, or a hematologic disorder. […] Patients with isolated thrombocytopenia commonly have drug-induced thrombocytopenia, immune thrombocytopenic purpura, pseudothrombocytopenia, or if pregnant, gestational thrombocytopenia. […] Thrombocytopenia can result from decreased platelet production, increased platelet consumption, or sequestration.

• #20 Thrombocytopenia – symptoms, causes, diagnosis and treatment | healthdirect

  https://www.healthdirect.gov.au/thrombocytopenia

  Thrombocytopenia is when you have low levels of platelets in your blood. […] There are many causes of thrombocytopenia. […] Treatment depends on the cause of your thrombocytopenia. […] Thrombocytopaenia can be caused by: medical conditions (such as problems with your bone marrow, liver disease, infections, immune conditions and blood clotting disorders) […] cancers (such as leukaemia, lymphoma or myeloma) […] some medicines, including heparin […] cancer treatments, including chemotherapy […] heavy alcohol use […] some nutritional deficiencies (vitamin B12 and folate deficiency) […] some genetic conditions […] pregnancy and some pregnancy complications. […] Immune thrombocytopenic purpura (ITP) also called immune thrombocytopenia is a condition that causes a low platelet count. ITP can affect children and adults and is caused by an immune system reaction. […] The AstraZeneca COVID-19 vaccine was linked to a very rare blood-clotting disorder called 'thrombosis with thrombocytopenia syndrome (TTS). This vaccine is no longer available in Australia.

• #21 How We Interpret Thrombosis with Thrombocytopenia Syndrome?

  https://www.mdpi.com/1422-0067/25/9/4956

  This review discusses the category of diseases presenting with thrombosis despite a low platelet count with reference to disease etiology, diagnostic methods, laboratory characteristics, and treatment. Approaches to differentiating these diseases in daily clinical practice are examined. […] Each of the thrombosis with thrombocytopenia syndrome (TTS) mentioned above is reviewed in terms of etiology, diagnostic methods, characteristics of laboratory data, and treatment. […] Antibodies against the platelet factor 4 (PF4)/heparin complex (HIT antibodies) are involved in the development of HIT. […] VITT caused by adenovirus vector vaccines results from the formation of autoantibodies (PF4/DNA complex antibodies: VITT antibodies) against a complex consisting of free DNA present in the vaccine and platelet factor 4 (PF4).

• #22 Hereditary Thrombocytopenia: Causes and Treatment

  https://www.healthline.com/health/hereditary-thrombocytopenia

  Hereditary thrombocytopenia, also called inherited thrombocytopenia, is a low platelet count caused by genetic factors, meaning parents carried genes that predisposed a child to the condition. […] Hereditary thrombocytopenia is caused by gene mutations inherited from birth. At least 40 genes associated with thrombocytopenia have been identified. […] The most common cause of inherited thrombocytopenia is MYH9-related disease. Its caused by mutations in the MYH9 gene. […] A low platelet count can be caused by genes inherited from your parents. More than 40 genes have been linked to hereditary thrombocytopenia, and more genes will likely be discovered in the future. […] Almost all inherited thrombocytopenia disorders are potentially curable with a bone marrow transplant. Bone marrow transplants are used to treat severe forms of inherited thrombocytopenia.

• #23 Thrombocytopenia – Wikipedia

  https://en.wikipedia.org/wiki/Thrombocytopenia

  Thrombocytopenia can be inherited or acquired. […] Abnormally low platelet production may be caused by dehydration, vitamin B12 or folic acid deficiency. […] Abnormally high rates of platelet destruction may be due to immune or nonimmune conditions, including immune thrombocytopenic purpura. […] These medications can induce thrombocytopenia through direct myelosuppression. […] Laboratory error, possibly due to the anticoagulant EDTA in CBC specimen tubes, may also be a cause.

• #24 Authentic and Spurious Causes of Thrombocytopenia (Online CE Course)

  https://www.labce.com/authentic-and-spurious-causes-of-thrombocytopenia.aspx?srsltid=AfmBOooCmMqcL1csnNA7V9uZE6cAPlrzhNXQFoQL-81xPrT9xO9FQPkB

  Platelets are the first responders to a bleeding incident. A decreased platelet force (thrombocytopenia) may be caused by several diseases or disorders. […] Identify conditions that cause the destruction of platelets. […] Identify conditions that cause decreased platelet production. […] Conditions causing increased destruction and consumption of platelets. […] Diseases and Disorders That Affect the Bone Marrow and Decrease Platelet Production. […] Other causes of thrombocytopenia. […] Variables that cause a false thrombocytopenia. […] Pseudo-thrombocytopenia: Platelet Satellitism and Platelet Clumping.

• #25 Evaluation of thrombocytopenia – Differential diagnosis of symptoms | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/795

  Thrombocytopenia results from either a reduced production of platelets in the bone marrow, increased clearance, sequestering of platelets in the spleen, or dilution. […] The causes of thrombocytopenia are diverse, making epidemiologic generalizations difficult. […] The differential diagnosis for a patient with new thrombocytopenia is broad and includes primary bone marrow disorders, chronic liver disease, infection, drug-related adverse effects, occult malignancy, and autoimmune/rheumatologic conditions. […] Primary ITP is diagnosed when there is no identifiable underlying condition following comprehensive patient evaluation.

• #26 Immune thrombocytopenic purpura (ITP) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/idiopathic-thrombocytopenic-purpura-itp

  Immune thrombocytopenic purpura (ITP) is a rare autoimmune disorder, in which a person’s blood doesn’t clot properly, because the immune system destroys the blood-clotting platelets. […] The cause of ITP is not known, but it is due to an immune system error that may be triggered by viral infections. […] It is thought that viral infections might make the immune system become overactive, and start producing abnormal antibodies. […] In other cases, the cause is unknown (idiopathic). […] Primary ITP is when the ITP is not associated with another disease. […] Secondary ITP is when it is associated with another disease such as autoimmune disease, chronic viral infection (such as HIV or hepatitis), primary immune deficiency, certain medications, or cancer.

• #27 What Causes Immune Thrombocytopenia? | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-immune-thrombocytopenia/what-causes-immune-thrombocytopenia

  In most cases, an autoimmune response is thought to cause immune thrombocytopenia (ITP). […] In ITP, however, your immune system attacks and destroys your body’s platelets by mistake. […] In some people, ITP may be linked to viral or bacterial infections, such as HIV, hepatitis C, or H. pylori. […] Children who have acute (short-term) ITP often have had recent viral infections. These infections may „trigger” or set off the immune reaction that leads to ITP.

• #28 What Is Immune Thrombocytopenia (ITP): Symptoms, Causes, Diagnosis, Treatment, and Prevention | Everyday Health

  https://www.everydayhealth.com/immune-thrombocytopenia/guide/

  ITP is usually the result of an autoimmune response, in which the immune system accidentally attacks itself. […] While its not entirely understood why this happens, ITP may be linked to certain infections, such as HIV, hepatitis C, or Helicobacter pylori (H. pylori), a type of bacteria that causes stomach ulcers. […] ITP is linked to a number of infections, including HIV, hepatitis C, and H. pylori. […] ITP can be triggered by viral infections, including COVID-19, as documented by one French study.

• #29 Drug-induced thrombocytopenia: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000556.htm

  Thrombocytopenia is any disorder in which there are not enough platelets. Platelets are elements in the blood that help the blood clot. A low platelet count makes bleeding more likely. […] When medicines or drugs cause a low platelet count, it is called drug-induced thrombocytopenia. […] Drug-induced thrombocytopenia occurs when certain medicines destroy platelets or interfere with the body’s ability to make enough of them. […] There are two types of drug-induced thrombocytopenia: immune and nonimmune. […] If a medicine causes your immune system to produce antibodies which seek and destroy your platelets, the condition is called drug-induced immune thrombocytopenia. Heparin, a blood thinner, is the most common cause of drug-induced immune thrombocytopenia. […] If a medicine prevents your bone marrow from making enough platelets, the condition is called drug-induced nonimmune thrombocytopenia. Chemotherapy drugs and a seizure medicine called valproic acid may lead to this problem. […] Other medicines that cause drug-induced thrombocytopenia include: Furosemide, Gold, used to treat arthritis, Nonsteroidal anti-inflammatory drugs (NSAIDs), Penicillin, Quinidine, Quinine, Ranitidine, Sulfonamides, Linezolid and other antibiotics, Statins.

• #30 Acquired Thrombocytopenia: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/acquired-thrombocytopenia

  Other causes of acquired thrombocytopenia include: pregnancy, cancers like leukemia or metastatic cancer, liver cirrhosis, hepatitis C, alcohol use disorder, some nutrient deficiencies like folate or vitamin B12, stem cell transplant, snakebites. […] Infections are one of the most common causes of acquired thrombocytopenia. Many viruses can trigger thrombocytopenia, including herpes viruses and the varicella-zoster virus that causes chickenpox. […] Acquired thrombocytopenia is a low platelet count that develops throughout your life. It can be temporary or permanent, depending on the cause.

• #31 Other Causes of a Low Platelet Count

  https://pdsa.org/other-causes-low-platelet-count

  Other Causes of a Low Platelet Count […] Liver disease is a common cause for thrombocytopenia. One reason is because thrombopoietin, a protein that stimulates the body to make platelets, is made in the liver. When a person has liver disease, they have a reduced amount of thrombopoietin and consequently, a reduced number of platelets. […] While the specific cause behind why ITP develops is usually unknown and can differ from person to person, it is known that numerous medications can cause a short term low platelet count. […] Almost all chemotherapy drugs used to treat cancer will affect the bone marrow, resulting in impaired platelet production. […] HIV and AIDS have been shown to cause a low platelet count. […] The liver makes a protein called thrombopoietin, that prompts the bone marrow to release platelets and clotting factors needed for bleeding to stop. Liver disease such as hepatitis C can cause both thrombocytopenia and increase clotting time.

• #32 Thrombocytopenia

  https://ouhsc.edu/platelets/Thrombocytopenia

  The cause of TTP is a deficiency of a blood enzyme that helps to prevent platelet clumping and the resulting formation of the tiny blood clots. […] Just like DITP, drugs can cause TMA by the formation of drug dependent antibodies. […] This is a TMA syndrome caused by an intestinal infection with a bacteria that secretes a very potent toxin, named Shiga toxin. […] This is a recently recognized cause, usually associated with an inherited gene mutation that causes an abnormality of the immune (complement) system.

• #33 Thrombocytopenia – EMCrit Project

  https://emcrit.org/ibcc/thrombocytopenia/

  Thrombocytopenia (150,000 platelets) is extremely common in the ICU. It is often a poor prognostic sign that is associated with systemic inflammation. […] Most cases of thrombocytopenia will resolve in parallel with the patient’s overall recovery. […] Drug-induced immune thrombocytopenia (D-ITP) […] Transfusion-related thrombocytopenia. […] Infection: EBV, VZV. […] Drugs toxins: Alcohol (direct marrow toxicity; can be suggested by macrocytosis; platelets should rise within 2-5 days of cessation). […] Primary bone marrow disorder: Myelodysplastic syndrome. […] Cirrhosis (reduced thrombopoietin production). […] Immune-mediated thrombocytopenia of any cause: D-ITP (drug-induced immune thrombocytopenia). […] HIT causes severe thrombocytopenia in ~10% of cases (generally, when HIT causes simultaneous DIC).

• #34 Thrombocytopenia (Low Platelet Count): Causes, Symptoms, and Treatment Options

  https://www.webmd.com/a-to-z-guides/thrombocytopenia-symptoms-causes-treatments

  Conditions or things that can cause your body to break platelets down too fast include: pregnancy, autoimmune diseases, including lupus or rheumatoid arthritis, bacterial or viral infections, medicines that make your immune system destroy platelets, certain rare conditions, including thrombotic thrombocytopenic purpura or hemolytic uremic syndrome. […] Conditions or things that can cause too many of your platelets to get lost or trapped include: alcohol abuse or alcohol use disorder, bleeding or hemorrhage, pregnancy, liver disease, blood clots in your lungs (pulmonary embolism), high blood pressure in your lungs (pulmonary hypertension). […] The most common reason for low platelet counts is another health condition or a medicine you’re taking for another health condition. Some other risk factors for low platelets include: family history, genetics, age.

• #35 Risk Factors of Thrombocytopenia | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-thrombocytopenia/risk-factors-thrombocytopenia

  People who are at highest risk for thrombocytopenia are those affected by one of the conditions or factors discussed in „What Causes Thrombocytopenia?” This includes people who: […] People at highest risk also include heavy alcohol drinkers and pregnant women.

• #36 Thrombocytopenia risk factors: What to know

  https://www.medicalnewstoday.com/articles/thrombocytopenia-risk-factors

  Even if the bone marrow produces enough platelets, several factors can cause the body to destroy them, which can lead to thrombocytopenia. These potential causes include: infectious diseases, such as mononucleosis and cytomegalovirus; autoimmune conditions, such as lupus, rheumatoid arthritis, and immune thrombocytopenia; some medications, such as nonsteroidal anti-inflammatory drugs, heparin, and quinine; surgery where the blood passes through artificial valves, machines, or tubing; pregnancy; some rare conditions that cause blood clots, such as thrombotic thrombocytopenic purpura. […] Common causes of thrombocytopenia include autoimmune diseases, certain medications, and infectious diseases. […] Lifestyle risk factors may include heavy alcohol consumption and taking OTC medications that affect platelet count or thin the blood. […] Usually, people cannot prevent the disorder. However, they may be able to decrease the risk of certain symptoms by avoiding medications that affect platelets and getting vaccinated against viruses that may cause the disorder.

• #37 Immune Thrombocytopenia (ITP): Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/5726-immune-thrombocytopenia

  Immune thrombocytopenia happens when your immune system clears your platelets from circulation and your platelet level goes down. […] What causes immune thrombocytopenia? Immune thrombocytopenia happens when your immune system makes antibodies that mistakenly identify your cells as being invaders, and then direct other immune cells to attack your platelets. […] Research shows people with human immunodeficiency virus (HIV), H. pylori infections or hepatitis C have an increased risk of developing ITP.

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