Thrombocytopenia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2], Farbod Zahedi Tajrishi, M.D. [2]

Overview

There are two broad mechanisms for the causes of thrombocytopenia: Reduced platelet production and increased platelet destruction. Thrombocytopenia is seen in a variety of infectious and genetic disorders as well as a side effect of a large list of medications.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Disseminated intravascular coagulation, endocarditis, pulmonary embolism
Chemical/Poisoning Strontium-89,zinc
Dental No underlying causes
Dermatologic Cholesterol embolism, Elejalde syndrome, Griscelli syndrome type 1, neuroectodermal melanolysosomal disease, post-transfusion purpura
Drug Side Effect Ado-trastuzumab emtansine, albendazole, alemtuzumab, altretamine, amiodarone, Amoxicillin, amphotericin B, amrinone, amsacrine, anagrelide, anazolene, anti-thymocyte globulin, ardeparin, Asenapine maleate, Aspirin, azathioprine, Azacitidine, Aztreonam, bendamustine, benoxaprofen, Beractant, bevacizumab, Boceprevir, bortezomib, bosutinib, brentuximab vedotin, cabazitaxel, Cabozantinib, capecitabine, captopril, carboplatin, carfilzomib, carmustine, caspofungin, Cefadroxil, Cefepime, Cefotaxime sodium, Ceftazidime, Cefaclor, Certolizumab pegol, Chlorpropamide , chlorambucil, chloramphenicol,clofarabine, Cidofovir, cilazapril, cimetidine, cisplatin, cladribine, Clemastine, clofarabine, Clobazam, Cyclophosphamide, Cytarabine, cytosine arabinoside, dacarbazine, Dactinomycin, dasatinib, daunorubicin, decitabine, deferasirox, desferrioxamine, Desmopressin, Dexchlorpheniramine, Dexrazoxane, Dextran Didanosine, diflunisal, docetaxel, Doxorubicin Hydrochloride, doxycycline, Rifampin drug-induced thrombocytopenia, efalizumab, eflornithine, Eltrombopag, enoxaparin, Epirubicin hydrochloride, eptifibatide, Eribulin, Ethambutol, Ethacrynic Acid, etoposide, everolimus, febuxostat, Felbamate, Filgastrim, flucytosine, fludarabine, fluorouracil, fondaparinux, foscarnet, ganciclovir, gemcitabine, gemtuzumab ozogamicin, glycoprotein IIb/IIIa inhibitors, gold salts, guanidinium, Guanidine, haem arginate, heparin, Hydrocodone bitartrate and acetaminophen, hydroxycarbamide, hydroxychloroquine, Hydroxyurea (patient information), ibitumomab tiuxetan, ibuprofen lysine, ibrutinib, idarubicin, ifosfamide, imatinib mesylate, Indinavir, indomethacin, integrilin, interferon alpha, interferon alfacon-1, Imipenem-Cilastatin,Interferon beta- 1a, Interferon gamma, interleukin 10, interleukin 2, irinotecan hydrochloride, Isoniazid, isotretinoin, ixabepilone, Lapatinib,lenalidomide, Letrozole, linezolid, lomustine, low molecular weight heparins, Loxapine, melphalan, mercaptopurine, Meropenem, methimazole, methotrexate, methyldopa, methyldopate, methylphenidate, micafungin sodium, Milnacipran hydrochloride, minocycline hydrochloride, miltefosine, mithramycin, mitomycin, mitoxantrone, MMR vaccine, montelukast, nabumetone, nelarabine, niacin, nilotinib, nitisinone, Nizatidine, obinutuzumab, Ofatumumab, Omacetaxine, omacetaxine mepesuccinate, Olsalazine, oxaliplatin, Oxaprozin, oxcarbazepine, Oxytetracycline, paclitaxel, Palbociclib, panobinostat, para-amino salicylic acid, pazopanib, Pegademase, Peginterferon Beta-1a,pemetrexed, penicillamine, pentamidine Isethionate, pentostatin, phenylbutazone, phenytoin, Pergolide, Pertuzumab, pixantrone, Plerixafor, pomalidomide, ponatinib, pralatrexate, pramipexole, procarbazine, promethazine, proton pump inhibitors, pyrimethamine, quinidine, quinine, Rabeprazole, Radium chloride, raltitrexed, ranitidine, regorafenib, reoPro, repaglinide, rifampicin, Ritonavir, rituximab, romidepsin, Romiplostim, ruxolitinib, Siltuximab, sirolimus, Sodium aurothiomalate, sorafenib, stiripentol, Streptozocin, Sulfacetamide, Sulfamethoxazole/Trimethoprim (oral), sulfasalazine, sulindac, sulfonamides, sunitinib malate, Spironolactone, Tacrolimus, Tamoxifen, temozolomide, temsirolimus, teniposide, thalidomide, thioguanine, thiotepa, Thiothixene, Tiagabine, ticlopidine, tinzaparin, tirofiban, tocilizumab, topotecan, Tolmetin, Tolazamide, Toremifene, tositumomab iodine-131, trabectedin, Trimethadione, trimethoprim-sulfamethoxazole, tolbutamide, valganciclovir, valproic acid, vancomycin, Vinblastine, Vincristine sulfate liposome vinflunine, vinorelbine, vorinostat, ziv-aflibercept, zonisamide
Ear Nose Throat Alport syndrome, Arias oculootoradial syndrome, Epstein's syndrome, Fechtner syndrome
Endocrine Immunodysregulation polyendocrinopathy and enteropathy, X-linked
Environmental No underlying causes
Gastroenterologic Dibasic aminoaciduria type 2, liver failure, Niemann-Pick disease type b, portal hypertension, Shwachman-Diamond syndrome
Genetic Aicardi-Goutieres syndrome, Alport syndrome, Chediak-Higashi disease, complement factor H deficiency, Elejalde syndrome, Fanconi anaemia, Fechtner syndrome, Griscelli syndrome type 1, holocarboxylase synthase deficiency, iminodipeptiduria, Jacobsen syndrome, MELAS, neuroectodermal melanolysosomal disease, Niemann-Pick disease type b, Omenn syndrome, Paris-Trousseau thrombocytopenia, Shwachman-Diamond syndrome, TAR syndrome, Thrombocytopenia absent radius syndrome, Von Willebrand disease, platelet type, Wiskott-Aldrich syndrome, X-linked hyperimmunoglobulin M syndrome
Hematologic Acquired pure megakaryocytic aplasia, aplastic anemia, Bernard-Soulier syndrome, congenital amegakaryocytic thrombocytopenia (CAMT), disseminated intravascular coagulation, Epstein's syndrome, familial histiocytic reticulosis, Gasser syndrome, GATA1-related cytopenia, Glanzmann's thrombasthenia, grey platelet syndrome, hemolytic uremic syndrome, histiocytosis X, hypersplenism, idiopathic thrombocytopenic purpura, Jacobsen syndrome, Kasabach-Merritt syndrome, May-Hegglin anomaly, Moschcowitz syndrome, myelodysplastic syndrome, myelofibrosis, neonatal alloimmune thrombocytopenia, pancytopenia, Paris-Trousseau thrombocytopenia, paroxysmal nocturnal hemoglobinuria, post-transfusion purpura, pulmonary embolism, radial aplasia-thrombocytopenia syndrome, Sebastian platelet syndrome, Shwachman-Diamond syndrome, thrombotic thrombocytopenic purpura, Von Willebrand disease, platelet type, Werlhof disease, Wiskott-Aldrich syndrome
Iatrogenic Cardiac bypass, chemotherapy, intra-aortic balloon pump placement, massive blood transfusion, radiation therapy
Infectious Disease Congenital syphilis, cytomegalovirus, Dengue fever, ehrlichiosis, Epstein-Barr virus, hantavirus, hepatitis C, HIV, human granulocytic ehrlichiosis, human monocytotropic ehrlichiosis, infections, infectious mononucleosis, lassa fever, leptospirosis, malaria, measles, mumps, mycoplasma pneumonia, Oklahoma tick fever, parvovirus, Q fever, rubella, septicaemia, tick-borne encephalitis, toxic shock syndrome (staphylococcal), varicella, visceral leishmaniasis
Musculoskeletal/Orthopedic Arias oculootoradial syndrome, cholesterol embolism, radial aplasia-thrombocytopenia syndrome, TAR syndrome, thrombocytopenia absent radius syndrome
Neurologic Aicardi-Goutieres syndrome, Jacobsen syndrome
Nutritional/Metabolic Dibasic aminoaciduria type 2, folate deficiency, Gaucher disease, holocarboxylase synthase deficiency, iminodipeptiduria, iron deficiency, isovaleric acidaemia, methylmalonic aciduria type 2, platelet glycoprotein 4 deficiency, platelet glycoprotein Ib deficiency, prolidase deficiency, propionyl-CoA carboxylase deficiency, sea blue histiocytosis, sitosterolemia, vitamin B12 deficiency
Obstetric/Gynecologic Eclampsia, HELLP syndrome, pre-eclampsia
Oncologic Acute lymphoblastic leukemia, acute myeloid leukemia, acute promyelocytic leukemia, chronic lymphocytic leukaemia, chronic myeloid leukaemia, hairy cell leukaemia, hepatosplenic T-cell lymphoma, histiocytosis X, Kasabach-Merritt syndrome, lymphoma, myeloma, Non-Hodgkins lymphoma, paraneoplastic syndrome
Ophthalmologic Arias oculootoradial syndrome
Overdose/Toxicity Alcohol, arsenic trioxide, ethanol
Psychiatric No underlying causes
Pulmonary Acute respiratory distress syndrome, Niemann-Pick disease type b, pulmonary embolism
Renal/Electrolyte Alport syndrome, cholesterol embolism, Dibasic aminoaciduria type 2, Epstein's syndrome, Fechtner syndrome, hemolytic uremic syndrome
Rheumatology/Immunology/Allergy Anticardiolipin syndrome, antiphospholipid syndrome, autoimmune lymphoproliferative syndrome type 1, autoimmune lymphoproliferative syndrome type 2, complement factor H deficiency, Evans syndrome, immunodysregulation polyendocrinopathy and enteropathy, X-linked, macrophage-activation syndrome, neonatal alloimmune thrombocytopenia, Omenn syndrome, paraneoplastic syndrome, systemic lupus erythematosus, Wiskott-Aldrich syndrome, X-linked hyperimmunoglobulin M syndrome
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Snakebites

Causes in Alphabetical Order

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 Stasi R (2012). "How to approach thrombocytopenia". Hematology Am Soc Hematol Educ Program. 2012: 191–7. doi:10.1182/asheducation-2012.1.191. PMID 23233580.
  2. 2.0 2.1 2.2 2.3 Greenberg EM, Kaled ES (2013). "Thrombocytopenia". Crit Care Nurs Clin North Am. 25 (4): 427–34, v. doi:10.1016/j.ccell.2013.08.003. PMID 24267279.
  3. Farid J, Gul N, Qureshi WU, Idris M (2012). "Clinical presentations in immune thrombocytopenic purpura". J Ayub Med Coll Abbottabad. 24 (2): 39–40. PMID 24397048.
  4. Nisha S, Amita D, Uma S, Tripathi AK, Pushplata S (2012). "Prevalence and characterization of thrombocytopenia in pregnancy in Indian women". Indian J Hematol Blood Transfus. 28 (2): 77–81. doi:10.1007/s12288-011-0107-x. PMC 3332269. PMID 23730013.
  5. Abdel Karim N, Haider S, Siegrist C, Ahmad N, Zarzour A, Ying J; et al. (2013). "Approach to management of thrombotic thrombocytopenic purpura at university of cincinnati". Adv Hematol. 2013: 195746. doi:10.1155/2013/195746. PMC 3876823. PMID 24396345.



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