Hematology Question 11 Instructor

Thrombocytopenia is traditionally taught with distinguishing between a bone marrow disorder, ruling out splenic sequestration, or peripheral destruction.

Discussion points: Discuss the differential diagnosis of thrombocytopenia.

Decreased production:

  • Congenital bone marrow disorders (TAR, Fanconi’s)
  • Aplasia (chemotherapy, radiation, alcohol, medications)
  • Infiltration
  • Hereditary disorders (May Hegglin, Bernard Soulier)
  • Nutritional deficiencies (n.b. – it can take 2 weeks for platelets to return to normal levels following replacement)


  • Splenomegaly (30% of plts are stored in the spleen)
  • Hypothermia
  • Dilution post massive transfusion


  • Immune mediated destruction (drug induced and chronic/acute immune thrombocytopenia)
  • Consumption (TTP, DIC, TTP, HUS, HELLP)

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