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Differential Diagnosis for Leukocytosis and Low Platelet Count

Single Most Likely Diagnosis

  • Sepsis: This condition is characterized by a systemic inflammatory response to infection, which can lead to leukocytosis (an increase in white blood cells) and thrombocytopenia (low platelet count) due to the consumption of platelets and the bone marrow's response to the infection.

Other Likely Diagnoses

  • Acute Leukemia: Certain types of leukemia, such as acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), can present with leukocytosis due to the proliferation of malignant white blood cells and thrombocytopenia due to bone marrow infiltration and suppression of normal hematopoiesis.
  • Disseminated Intravascular Coagulation (DIC): This condition involves both clotting and bleeding and can result in thrombocytopenia and leukocytosis as the body attempts to respond to the widespread activation of the coagulation system.
  • Infectious Mononucleosis: Caused by Epstein-Barr virus (EBV), this infection can lead to leukocytosis with atypical lymphocytes and sometimes thrombocytopenia due to immune-mediated mechanisms.

Do Not Miss Diagnoses

  • Thrombotic Thrombocytopenic Purpura (TTP): A rare disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, renal failure, and neurological symptoms. It is crucial to diagnose TTP promptly because it is life-threatening and requires immediate treatment with plasma exchange.
  • Hemophagocytic Lymphohistiocytosis (HLH): A rare, potentially life-threatening condition of the immune system where it produces too many activated immune cells called macrophages and lymphocytes. These cells infiltrate various tissues and can lead to organ damage, presenting with leukocytosis and thrombocytopenia among other findings.
  • Severe Malaria: Certain species of Plasmodium, like P. falciparum, can cause severe malaria, which may present with leukocytosis and thrombocytopenia due to the parasite's effect on the bone marrow and the consumption of platelets.

Rare Diagnoses

  • Myeloproliferative Neoplasms (MPNs): Conditions like essential thrombocythemia, polycythemia vera, and primary myelofibrosis can sometimes present with thrombocytopenia (especially in the later stages or due to transformation) and leukocytosis due to the abnormal proliferation of bone marrow cells.
  • Lymphoma: Certain types of lymphoma can cause leukocytosis and thrombocytopenia, especially if there is significant bone marrow involvement.
  • Paroxysmal Nocturnal Hemoglobinuria (PNH): A rare, acquired, life-threatening disease of the blood characterized by the destruction of red blood cells, bone marrow failure, and the potential for thrombosis, which can sometimes present with leukocytosis and thrombocytopenia.

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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