Thrombocytopenia ? how to diagnosis which type?

Question

There are so many different causes, and categorized by fail platelet production, or fail platelet survival... What I want to know is how to diagnose the cause.

Answer 1

Basically, thrombocytopenia is a decreased platelet count in blood. It takes a lot of series of tests relative to platelets such as (a) platelet function tests; (b) platelet adhesiveness; (c) platelet antibodies; etc... It depends, actually, from the results obtained based on the above-mentioned tests.

Even when you have low platelet count, usually, doctor will request platelet reticulocytes. What does this mean? Reticulocytes are young/immature cells, in this case, the platelets.Lab test for platelet reticulocytes is run to see if the body would be able to compensate to produce any platelet loss or damage in the body, if it's normal and high, then it's a good sign , however, if it's low, then something is wrong. The cause might be a "platelet antibody", meaning body is producing an antibody to fight/destroy its own platelets thus the number is decreased and cannot compensate to make new ones...Hope this helps...

Answer 2

I'm a hematologist - MD blood specialist. The answer above is not quite right. Let's keep it simple. Thrombocytopenia is a decrease in the "number" of platelets, so we don't need to jump into complex studies of platelet "quality" or function.
It's quantity that you care about here.
Very simply - You are either not making them OR your are breaking them. I could check an inexpensive CBC, look at the blood smear, and tell you quite a bit without great expense or discomfort.
Sometimes it's a simple lab error and is OK when repeated.
The easiest things to fix are drug related side effects.
Many drugs (and chronic alcohol abuse) can cause a low platelet count). Sometimes you just need to stop taking meds (and alcohol) for a few weeks and recheck the platelet count.
If you do have anti-platelet antibodies - what we call "ITP"
(you don't want the long name) - it gets more complicated diagnosing and treating.
Start simple with a repeat CBC and make sure someone who can read blood smears has a good look at the slides.
The history and physical exam help a great deal too.
Is there bruising? Is the spleen enlarged? etc.
Let's leave it at this point, or I'll be writing a book.
Good Luck
Added Note - It would help to tell us what the platelet count is along with the other blood cell counts.