Jali Ayanda G P, Nkambule Bongani B
Department of Haematology, Health King Edward VIII Hospital, University of Kwa-Zulu Natal, Durban, South Africa.
Department of Haematology, National Health Laboratory service, Inkosi Albert Luthuli Academic Hospital, Durban, South Africa.
Afr J Lab Med. 2020 Aug 24;9(1):799. doi: 10.4102/ajlm.v9i1.799. eCollection 2020.
Thrombocytopenia is a common haematological disorder, characterised by platelet counts below 150 × 10/L. The aetiology of thrombocytopenia is multifactorial; notably, in a misdiagnosis this condition may be due to pre-analytical laboratory artefacts. Knowledge about the common aetiology of thrombocytopenia will assist clinicians in decision-making and interpretation of laboratory tests and this may lead to prompt, adequate patient management and cost-saving measures.
This study determined the prevalence and aetiology of moderate and severe thrombocytopenia in a tertiary or quaternary laboratory in Durban, KwaZulu-Natal, South Africa.
We conducted a retrospective study at the Inkosi Albert Luthuli Central Hospital haematology laboratory between October 2015 and April 2016. A total of 2076 full blood count results with a platelet count of less than 100 × 10/L were retrieved from the Inkosi Albert Luthuli Academic Hospital database. Laboratory data were extracted and matched with clinical data and used to identify the potential aetiology of thrombocytopenia.
The prevalence of thrombocytopenia was 14.9% within the selected study period. The haematology or oncology wards and clinic accounted for 55.2% of thrombocytopenia cases, whereas the adult and paediatric intensive care units accounted for 29.3%. Notably, 15.5% of thrombocytopenia cases were reported in non-haematology wards and clinics. The most common cause of thrombocytopenia was chemotherapy which accounted for 38.5% of all causes.
In our tertiary and quaternary setting, thrombocytopenia in adults was most common in patients admitted to haematology and oncology wards. Moreover, chemotherapy-induced thrombocytopenia accounted for more than a third of all these cases.
血小板减少症是一种常见的血液系统疾病，其特征为血小板计数低于150×10⁹/L。血小板减少症的病因是多因素的；值得注意的是，在误诊情况下，这种情况可能是由于分析前实验室假象所致。了解血小板减少症的常见病因将有助于临床医生进行决策以及解读实验室检查结果，这可能会带来及时、恰当的患者管理和节省成本的措施。
本研究确定了南非夸祖鲁 - 纳塔尔省德班一家三级或四级实验室中中度和重度血小板减少症的患病率及病因。
我们于2015年10月至2016年4月在因科西·阿尔伯特·卢图利中央医院血液学实验室进行了一项回顾性研究。从因科西·阿尔伯特·卢图利学术医院数据库中检索了总共2076份血小板计数低于100×10⁹/L的全血细胞计数结果。提取实验室数据并与临床数据匹配，以确定血小板减少症的潜在病因。
在选定的研究期间，血小板减少症的患病率为14.9%。血液学或肿瘤学病房及门诊占血小板减少症病例的55.2%，而成人及儿科重症监护病房占29.3%。值得注意的是，15.5%的血小板减少症病例报告于非血液学病房及门诊。血小板减少症最常见的原因是化疗，占所有病因的38.5%。
在我们的三级和四级医疗机构中，成人血小板减少症在血液学和肿瘤学病房的患者中最为常见。此外，化疗引起的血小板减少症占所有这些病例的三分之一以上。
