Department of Haematology and Central Haematology Laboratory, University Hospital Inselspital, Bern, Switzerland.
Hamostaseologie. 2013 May 29;33(2):83-94. doi: 10.5482/HAMO-13-01-0003. Epub 2013 Mar 27.
Solving the riddle of a thrombocytopenic patient is a difficult and fascinating task. The spectrum of possible aetiologies is wide, ranging from an in vitro artefact to severe treatment-resistant thrombocytopenic bleeding conditions, or even life-threatening prothrombotic states. Moreover, thrombocytopenia by itself does not protect from thrombosis and sometimes a patient with a low platelet count requires concomitant antithrombotic treatment as well. In order to identify and treat the cause and the effects of the thrombocytopenia, you have to put together several pieces of information, solving a unique jig-jaw puzzle. The present work is not a textbook article about thrombocytopenia, rather a collection of differential diagnostic thoughts, treatment concepts, and some basic knowledge, that you can retrieve when facing your next thrombocytopenic patient. Enjoy reading it, but most importantly enjoy taking care of patients with a low platelet count. I bet the present work will assist you in this challenging and rewarding clinical task.
解决血小板减少症患者的问题是一项艰巨而又引人入胜的任务。可能的病因范围很广，从体外人为因素到严重的治疗抵抗性血小板减少性出血情况，甚至是危及生命的血栓前状态。此外，血小板减少本身并不能预防血栓形成，有时血小板计数低的患者也需要同时进行抗血栓治疗。为了确定和治疗血小板减少症的原因和影响，您必须综合考虑一些信息，就像解决一个独特的拼图难题一样。本文不是关于血小板减少症的教科书文章，而是收集了一些鉴别诊断思路、治疗理念和一些基础知识，以便在面对下一位血小板减少症患者时可以随时查阅。希望您阅读愉快，但最重要的是，希望您能在照顾血小板减少症患者的过程中获得乐趣。我相信，本文将有助于您完成这一具有挑战性和回报的临床任务。
