Causes of decreased bone marrow production of platelets

• Marrow failure: aplastic anaemia (ffl p122).

• Marrow infiltration: leukaemias, myelodysplasia, myeloma, myelofi-brosis, lymphoma, metastatic carcinoma.

• Marrow suppression: cytotoxic drugs and radiotherapy, other drugs (e.g. chloramphenicol).

• Selective megakaryocytic: ethanol, drugs (phenylbutazone, co-trimoxa-zole; penicillamine), chemicals, viral infection (e.g. HIV, parvovirus).

384 • Nutritional deficiency: megaloblastic anaemia (ffl p60-62).

• Hereditary causes (rare): Fanconi's syndrome (ffl p456), congenital megakaryocytic hypoplasia, absent radii (TAR) syndrome.

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