Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (391 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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   Hypersplenism
   Drug-related thrombocytopenia in the mother
   Hypersplenism in neonates with an an enlarged spleen
   Necrotizing enterocolitis
   Laboratory studies are directed to the underlying condition and monitoring the platelet counts.

Decreased Production

   Genetic disorders: thrombocytopenia-absent radius syndrome; congenital megakaryocytic thrombocytopenia; Fanconi anemia; certain chromosome abnormalities; congenital platelet disorders; lipid storage diseases
   Acquired causes: bone marrow diseases (neonatal leukemia, neuroblastoma); toxic injury to megakaryocytes due to drugs or infections; neonates whose mothers have preeclampsia; birth asphyxia; following exchange transfusion
   Laboratory Findings
   Serial platelet counts
   Maternal studies for thrombocytopenia
   DIC screening in infants at risk for DIC
PSEUDO (SPURIOUS) THROMBOCYTOPENIA
   Definition

A false decrease in reported platelet counts. It may be due to:

   Platelet clumping induced by collection of blood in EDTA (the routine anticoagulant used for CBC); it is the most common cause for spurious thrombocytopenia. In a good laboratory, the technicians observe all CBC tubes flagged for low platelets for the presence of clots and review stained peripheral blood smear (PBS) for clumps.

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