University Hospitals Sussex NHS Foundation Trust, Brighton, UK and Brighton and Sussex Medical School, Falmer, UK
University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
Clin Med (Lond). 2022 May;22(3):214-217. doi: 10.7861/clinmed.2022-0146.
New thrombocytopenia may be associated with a variety of conditions and diagnosis can be challenging. Presentation can vary from life-threatening bleeding or thrombosis to an incidental finding in an asymptomatic patient. New thrombocytopenia requires urgent investigation. Investigations are mainly guided by findings from the clinical history, physical examination, full blood count and blood film analysis. Aside from the actively bleeding patient, rare but life-threatening causes of thrombocytopenia must be identified early as they require urgent treatment. These include thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, suspicion of new acute promyelocytic leukaemia, and vaccine-induced prothrombotic immune thrombocytopenia. Here, we discuss how to approach a patient with new thrombocytopenia, along with key differentials not to be missed.
新出现的血小板减少症可能与多种情况有关，诊断可能具有挑战性。其表现形式多种多样，从危及生命的出血或血栓形成到无症状患者的偶然发现。新出现的血小板减少症需要紧急调查。调查主要根据临床病史、体格检查、全血细胞计数和血片分析的结果来指导。除了正在出血的患者外，还必须早期识别罕见但危及生命的血小板减少症的原因，因为这些原因需要紧急治疗。这些原因包括血栓性血小板减少性紫癜、弥漫性血管内凝血、疑似新发急性早幼粒细胞白血病和疫苗诱导的促血栓形成免疫性血小板减少症。在这里，我们讨论如何处理新出现的血小板减少症患者，以及需要注意的关键鉴别诊断。
