Immune Thrombocytopenic Purpura (ITP): This condition is characterized by low platelet count due to immune-mediated destruction. A high immature platelet fraction (IPF) indicates the bone marrow's attempt to compensate for the peripheral destruction of platelets, making ITP a plausible diagnosis.

Bone Marrow Failure Syndrome (e.g., Myelodysplastic Syndrome): These syndromes can lead to ineffective hematopoiesis, resulting in thrombocytopenia. A high IPF may reflect the bone marrow's attempt to increase platelet production in response to peripheral demand or destruction.
Chronic Liver Disease: Liver diseases, such as cirrhosis, can lead to thrombocytopenia due to splenic sequestration. A high IPF could indicate an attempt to compensate for the decreased platelet count.
Viral Infections (e.g., HIV, Hepatitis C): Certain viral infections can cause thrombocytopenia through immune-mediated mechanisms or direct bone marrow suppression. A high IPF might be seen as the body attempts to recover from the infection.

Thrombotic Thrombocytopenic Purpura (TTP): Although less common, TTP is a critical diagnosis to consider due to its high mortality rate if left untreated. It presents with thrombocytopenia, microangiopathic hemolytic anemia, renal failure, neurological symptoms, and fever. A high IPF could be seen in the context of intense platelet consumption.
Heparin-Induced Thrombocytopenia (HIT): If the patient has been exposed to heparin, HIT is a potentially life-threatening condition that must be considered. It involves an immune-mediated response against heparin, leading to thrombocytopenia and a prothrombotic state.
Disseminated Intravascular Coagulation (DIC): This condition, characterized by both clotting and bleeding, can present with thrombocytopenia. A high IPF might be observed due to the consumption of platelets in the formation of widespread clots.

Congenital Thrombocytopenias: These are a group of rare disorders characterized by thrombocytopenia present from birth. While unlikely in a 60-year-old presenting for the first time, some forms may not be diagnosed until later in life.
Thrombocytopenia with Absent Radius (TAR) Syndrome: An extremely rare condition characterized by thrombocytopenia and bilateral absence of the radius. It's unlikely to be diagnosed for the first time in a 60-year-old but is mentioned for completeness.
May-Hegglin Anomaly: A rare genetic disorder affecting platelet function and morphology, leading to thrombocytopenia. It's another condition that, although unlikely, could potentially present later in life if mild.