Investigation of thrombocytopenia

• History—drugs, symptoms of viral illness.

• Examination—signs of infection, lymphadenopathy, hepatosplenomegaly.

• FBC—isolated thrombocytopenia or associated disorders.

• Blood film—red cell fragmentation (DIC), WBC differential (atypical lymphocytes/blasts), platelet size (large in ITP and some hereditary conditions), platelet clumps (pseudothrombocytopenia).

• Serology—antinuclear antibody, DAT, monospot, antiplatelet antibodies (unreliable), platelet-associated antibodies (unreliable), HIV serology.

• Routine chemistry—renal disease, hepatic disease.

• BM examination—megakaryocyte numbers, marrow disease or infiltration.

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