Differential Diagnosis of Thrombocytopenia According to Clinical Context
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According to clinical context:
- Outpatient:
- Isolated thrombocytopenia:
- Pseudothrombocytopenia
- Immune thrombocytopenia
- Primary – no underlying causative condition
- Secondary – associated with:
- Other autoimmune disorders
- Immunodeficiency syndrome
- Infections such as HIV and HCV
- Recent vaccinations
- Certain medications, including quinine
- Chronic lymphocytic leukemia
- Posttransplant autoimmune lymphoproliferative syndrome
- Alcohol abuse
- Cirrhosis
- Antiphospholipid syndrome
- Congenital (familial) thrombocytopenia
- Thrombocytopenia associated with other changes on the complete blood count:
- Non-malignant:
- Cirrhosis
- Post chemotherapy
- Malignant:
- Myelodysplasia (MDS)
- Myeloproliferative neoplasms (MPNs)
- MDS/MPN overlap syndrome
- Chronic lymphocytic leukemia
- Plasma cell dyscrasia
- Non-malignant:
- Isolated thrombocytopenia:
- Obstetrical outpatient:
- Gestational thrombocytopenia
- Immune thrombocytopenia
- Antiphospholipid syndrome
- Emergency department:
- Alcohol toxicity
- Immune thrombocytopenia (ITP) with bleeding
- TTP
- HUS
- DIC
- Venous thromboembolism (VTE) with large clot burden
- Dilutional thrombocytopenia from massive transfusion
- Inpatient (new onset):
- Medical:
- Medications, especially heparin
- Infection with or without DIC
- Hemophagocytic lymphohistiocytosis (HLH)
- Surgical:
- Postoperative thrombocytopenia, especially in orthopedic surgery
- VTE with large clot burden
- Medications, especially heparin
- Infection with or without DIC
- Intensive care unit (ICU):
- Medications, especially heparin
- Infection with or without DIC
- Extracorporeal circuits
- HLH
- Dilutional thrombocytopenia from massive transfusion
- Coronary care unit (CCU):
- Medications including
- Antiplatelet agents
- Heparin
- Extracorporeal circuits
- Medications including
- Obstetrics:
- Antiphospholipid syndrome
- HELLP
- HUS
- TTP
- Eclampsia
- Dilutional from treatment of postpartum hemorrhage
- Medical:
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