Authentic and Spurious Causes of Thrombocytopenia

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Author: Betty Ciesla MS, MLS(ASCP)SH
Reviewers: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM and Barbara Caldwell, MS, MLS(ASCP)SH

Platelets are the first responders to a bleeding incident. If the full platelet force does not arrive on the scene, bleeding will continue and petechiae, bruises, and perhaps even hemorrhaging will occur. A decreased platelet force (thrombocytopenia) may be caused by several diseases or disorders. On the other hand, a low platelet count may not actually mean that the full platelet force is not available to respond. It is up to the laboratory professional to determine if there is anything in the collection procedure that has artificially produced this low count. This course will increase your understanding of various authentic causes of thrombocytopenia and will alert you to various causes of spurious thrombocytopenia that you, as a medical laboratory scientist should be able to recognize and correct to prevent false reporting of thrombocytopenia.

Continuing Education Credits

Objectives

  • Define thrombocytopenia.
  • Recognize clinical signs that are associated with thrombocytopenia.
  • Identify conditions that cause the destruction of platelets.
  • Describe current treatments for various conditions that cause thrombocytopenia.
  • Identify conditions that cause decreased platelet production.
  • Recognize and correct falsely-decreased platelet counts.

Course Outline

  • Introduction
      • Definition of Thrombocytopenia
      • Signs Associated With Thrombocytopenia
      • Which of the following is a clinical sign that is associated with thrombocytopenia?
  • Conditions causing increased destruction and consumption of platelets
      • Increased Platelet Destruction
    • Idiopathic Thrombocytopenic Purpura
      • Immune Thrombocytopenic Purpura (ITP)
      • Acute Idiopathic Thrombocytopenia
      • Chronic Idiopathic Thrombocytopenic Purpura
      • Thrombocytopenia in Neonates
      • Treatment for ITP
      • Match each of the statements listed below with the type of ITP with which it is most closely associated.
    • Drug-Induced Thrombocytopenia
      • Drug-Induced Thrombocytopenia
      • Pathophysiology of Heparin-Induced Thrombocytopenia (HIT)
      • Additional Complications Related to Heparin-Induced Thrombocytopenia
      • True or False: When heparin-induced thrombocytopenia occurs, the platelet count noticeably decreases IMMEDIATELY after heparin treatment begins.
    • Thrombotic Thrombocytopenic Purpura and Hemolytic Uremic Syndrome
      • Thrombotic Thrombocytopenic Purpura (TTP) and Hemolytic Uremic Syndrome (HUS)
      • Laboratory Findings
      • Treatment of TTP
      • Which of the following bacteria is often linked to diarrhea-associated hemolytic uremic syndrome?
    • Disseminated Intravascular Coagulation
      • Disseminated Intravascular Coagulation (DIC)
      • Clinical Signs and Symptoms
      • Laboratory Findings
      • Treatment of DIC
      • Which of the following laboratory results would you find with disseminated intravascular coagulation (DIC) but NOT with thrombotic thrombocytopenic pu...
  • Conditions causing decreased platelet production
      • Diseases and Disorders That Affect the Bone Marrow and Decrease Platelet Production
      • True or False: Patients undergoing chemotherapy treatments will have deficiencies in platelet numbers as well as red and white blood cells.
  • Other causes of thrombocytopenia
      • Increased Splenic Sequestration and Thrombocytopenia
      • Dilutional Thrombocytopenia
  • Variables that cause a false thrombocytopenia
      • Pre-Examination Variables Leading to False Thrombocytopenia
      • Pseudo-thrombocytopenia: Platelet Satellitism and Platelet Clumping
      • Importance of Addressing Platelet Variables
      • Which of these conditions is associated with a pseudo-thrombocytopenia?
  • References
      • References

Additional Information

Level of instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, pathology residents, MLS students, and other health care personnel who have an interest in this subject matter.
Author information: Betty Ciesla, MS, MLS(ASCP)SH is a faculty member at Morgan State University in Maryland. She holds an MS degree in Biomedical Communication. She has presented at national workshops in Hematology and Coagulation, authored several book chapters and articles on topics in Hematology, and served on the ASCP’s Tech Sample Committee, Education Program Committee, and most recently, the Hematology Examination Committee.
Reviewer Information:  
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Barbara Caldwell, MS, MLS(ASCP)SH is the administrative director of clinical laboratory services at Montgomery General Hospital in Olney, Maryland. She is also an experienced educator, having served as a Clinical Assistant Professor at the University of Maryland School of Medicine in the Department Of Medical and Research Technology. Ms. Caldwell holds an MS degree from the University of Maryland School of Medicine. She has authored numerous textbook chapters, articles, and abstracts related to topics in Hematology.

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satellitism
Patient with petechiae and purpura (1).
Schistocytes
Normal platelet count on a peripheral blood smear.
The chemical formula for heparin.
A diagram depicting a pulmonary embolism.
A transfusion.
platelet clumps copy