What are the causes of thrombocytopenia (low platelet count)?

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Last updated: May 23, 2025View editorial policy

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Differential Diagnosis for Mildly Low Platelet Count

  • Single most likely diagnosis
    • Idiopathic thrombocytopenic purpura (ITP): This is an autoimmune condition where the body's immune system mistakenly attacks and destroys platelets, leading to a low platelet count. It is a common cause of isolated thrombocytopenia.
  • Other Likely diagnoses
    • Viral infections (e.g., HIV, hepatitis C): Certain viral infections can lead to a low platelet count due to immune system dysregulation or bone marrow suppression.
    • Medication-induced thrombocytopenia: Various medications, such as heparin, aspirin, and certain antibiotics, can cause a low platelet count as a side effect.
    • Hypersplenism: Enlargement of the spleen can lead to sequestration of platelets, resulting in a low platelet count.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Thrombotic thrombocytopenic purpura (TTP): A rare but life-threatening condition characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal failure.
    • Hemolytic uremic syndrome (HUS): A condition similar to TTP, often caused by E. coli infection, leading to thrombocytopenia, hemolytic anemia, and renal failure.
    • Disseminated intravascular coagulation (DIC): A condition characterized by widespread clotting and bleeding, which can lead to a low platelet count and other coagulation abnormalities.
  • Rare diagnoses
    • Congenital thrombocytopenias (e.g., Wiskott-Aldrich syndrome, Bernard-Soulier syndrome): Rare genetic disorders that affect platelet production or function.
    • Bone marrow failure syndromes (e.g., aplastic anemia, myelodysplastic syndromes): Conditions that affect the bone marrow's ability to produce blood cells, including platelets.
    • Lymphoproliferative disorders (e.g., lymphoma, leukemia): Certain types of cancer that can affect the bone marrow and lead to a low platelet count.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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