Differential Diagnosis of Thrombocytopenia According to Mechanism

According to the mechanism of thrombocytopenia

• Decreased production:
  • Isolated thrombocytopenia (rare):
    • Alcohol toxicity (suppression of platelet production)(suppression of platelet production)
    • Amegakaryocytic thrombocytopenia
    • Medications, including:
      • Linezolid (suppression of platelet production)
      • Bortezomib (inhibition of proplatelet formation of megakaryocytes)
      • Thiazide diuretics (selective suppression of megakaryocyte production, may also cause immune-mediated destruction of platelets)
      • Chlorothiazide
    • Infections such as HIV and HCV (may also cause immune-mediated destruction of platelets)
    • Congenital thrombocytopenia
  • Thrombocytopenia associated with changes in other hematopoietic cell lines, for example with/in:
    • Infiltrative disorders of bone marrow
    • Aplastic anemia
    • Megaloblastic anemia
    • Chemotherapy
• Increased consumption/destruction:
  • Consumption:
    • Thrombotic microangiopathy including:
      • Thrombotic thrombocytopenic purpura (TTP)
      • Atypical hemolytic uremic syndrome (aHUS)
      • Disseminate intravascular hemolysis (DIC)
    • Extracorporeal devices
    • Antiphospholipid syndrome
  • Antibody-mediated destruction
    • Immune thrombocytopenia
    • Antiphospholipid syndrome
    • Medications
  • Infection – for example babesiosis and anaplasmosis
• Sequestration – hypersplenism, especially in setting of cirrhosis.