Vnitr Lek 2010, 56(Suppl 1):104-108

The strategy of laboratory diagnostics and differential diagnostics of thrombocytopenia

M. Kušnierová^*, P. Kessler

Oddělení hematologie a transfuziologie Nemocnice Pelhřimov, p.o., přednosta prim. MUDr. Petr Kessler

Thrombocytopenia is a pathological state characterized by decreased platelet count under the lower limit of the physiological range, i.e. 150 × 10⁹ per liter. This disorder can be associated with clinical manifestation of the hemorrhagic diathesis. The risk of bleeding is closely associated with the depth of platelets count decrease. Spontaneous bleeding (in absence of any other coagulation disorder) usually occurs when the platelet count decreases below 20 × 10⁹ per liter. The first step, which should be done, when a newly diagnosed thrombocytopenia occurs, is a thorough review of a blood smear. Firstly, it is necessary to exclude the pseudothrombocytopenia, caused by an abnormal in vitro aggregation of thrombocytes, or (much less frequently) by platelet satelitism. It is also necessary to evaluate the red and white cells, especially to focus on the presence of schistocytes or blasts. Thereafter it is recommended to follow a standard diagnostic algorithm, which should be available in every hematological laboratory.

Keywords: laboratory diagnostics; thrombocytopenia; pseudothrombocytopenia

Received: March 31, 2010; Published: February 1, 2010  Show citation