Assessment

Knowledge of the patient's medical and drug history, previous blood counts, and examination for features of hemorrhage and underlying disorder can aid diagnosis and management. Initially, a full blood count and film will help to determine if other lineages are involved, and may be of use in identifying the etiology (e.g. platelet clumping producing an artefactually low count, malarial parasites, or features of a microangiopathic process). A sample should also be sent to determine whether a coagulopathy is also present. Further tests should be chosen in clinical context. Discussion with a hematologist regarding likely etiology, further investigations (e.g. bone marrow, specific antibody tests), and management is then advised.

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