Differential Diagnosis for Increased H&H and Decreased PLT
- Single Most Likely Diagnosis
- Immune Thrombocytopenic Purpura (ITP): This condition is characterized by low platelet count due to immune-mediated destruction. Increased H&H (hemoglobin and hematocrit) might not be directly related but can be seen in cases of bleeding or hemolysis. ITP is a common cause of isolated thrombocytopenia.
- Other Likely Diagnoses
- Thrombotic Thrombocytopenic Purpura (TTP): A disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, renal failure, and neurological symptoms. The increased H&H could be due to hemolysis, and decreased PLT is a hallmark.
- Hemolytic Uremic Syndrome (HUS): Similar to TTP, HUS presents with thrombocytopenia, hemolytic anemia, and renal failure. The increased H&H might reflect the hemolytic process.
- Disseminated Intravascular Coagulation (DIC): A condition characterized by both clotting and bleeding due to consumption of platelets and clotting factors. It can lead to thrombocytopenia and alterations in H&H due to bleeding or hemolysis.
- Do Not Miss Diagnoses
- Sepsis: Can cause thrombocytopenia due to consumption and increased H&H due to dehydration or hemolysis. Missing sepsis can be fatal.
- Malignancy (e.g., Lymphoma, Leukemia): Certain cancers can cause thrombocytopenia and alterations in H&H through bone marrow infiltration or paraneoplastic syndromes. These conditions require prompt diagnosis and treatment.
- Rare Diagnoses
- Thrombocytopenia with Absent Radius (TAR) Syndrome: A rare genetic disorder characterized by thrombocytopenia and bilateral absence of the radius. It's less likely to present with increased H&H but is a consideration in congenital cases.
- Wiskott-Aldrich Syndrome: An X-linked recessive disorder characterized by eczema, thrombocytopenia, and recurrent infections. While rare, it's an important consideration in male children with unexplained thrombocytopenia and other systemic symptoms.