What Specialty Treats Low Platelet Levels
Hematology is the medical specialty that treats thrombocytopenia (low platelet levels). 1
Primary Management by Hematologists
Hematologists manage all forms of thrombocytopenia, including immune thrombocytopenia (ITP), drug-induced thrombocytopenia, myelodysplastic syndromes, and other platelet disorders 1
The American Society of Hematology publishes comprehensive guidelines for the diagnosis and management of ITP, establishing hematology as the definitive specialty for thrombocytopenia care 1
Hematology consultation is commonly requested for both inpatient and outpatient evaluation of thrombocytopenia 2, 3
When Hematology Referral is Indicated
Patients with newly diagnosed ITP and platelet counts <20 × 10⁹/L should receive expedited follow-up with a hematologist, even if managed as outpatients 1
Children with chronic ITP (lasting >6 months) should be referred to a specialist hematology center 1
Adults with persistent thrombocytopenia requiring second-line therapy beyond corticosteroids need hematology management for treatments including thrombopoietin receptor agonists, rituximab, fostamatinib, or splenectomy 1
Scope of Hematology Management
Hematologists provide comprehensive care including:
Diagnostic evaluation with peripheral blood smear examination, bone marrow examination when indicated, and exclusion of secondary causes 1, 4
First-line treatment decisions regarding corticosteroids, intravenous immunoglobulin, or observation based on platelet count and bleeding symptoms 1
Advanced therapies including thrombopoietin receptor agonists (eltrombopag, romiplostim), rituximab, and immunosuppressive agents 1, 5, 6
Procedural management including determining appropriate platelet transfusion thresholds for invasive procedures 1
Long-term monitoring for treatment response, adverse effects, and disease progression 1
Multidisciplinary Involvement
While hematology is the primary specialty, other specialists may be involved depending on the underlying cause:
Oncologists manage chemotherapy-induced thrombocytopenia in cancer patients 1, 7
Hepatologists address thrombocytopenia related to chronic liver disease and portal hypertension 7, 5
Infectious disease specialists evaluate thrombocytopenia associated with HIV or other infections 1, 4
However, hematology remains the coordinating specialty for diagnosis and treatment of the thrombocytopenia itself, regardless of the underlying etiology 1, 2