Differential Diagnosis for Severe Thrombocytopenia in a 6-Year-Old Girl
Single Most Likely Diagnosis
- Idiopathic Thrombocytopenic Purpura (ITP): This is the most common cause of severe thrombocytopenia in children, characterized by isolated thrombocytopenia without other significant abnormalities. It is often preceded by a viral infection and can present with petechiae, bruising, and sometimes bleeding.
Other Likely Diagnoses
- Viral Infections: Certain viral infections such as HIV, hepatitis C, and CMV can cause thrombocytopenia due to bone marrow suppression or immune-mediated destruction of platelets.
- Autoimmune Disorders: Conditions like systemic lupus erythematosus (SLE) can lead to thrombocytopenia due to autoantibody production against platelets.
- Medication-Induced Thrombocytopenia: Certain medications, including heparin, quinine, and sulfonamides, can induce thrombocytopenia as a side effect.
Do Not Miss Diagnoses
- Thrombotic Thrombocytopenic Purpura (TTP): A rare but life-threatening condition characterized by thrombocytopenia, microangiopathic hemolytic anemia, renal failure, and neurological symptoms. Prompt diagnosis and treatment are crucial.
- Hemolytic Uremic Syndrome (HUS): Typically presents with thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury, often following a diarrheal illness caused by E. coli O157:H7.
- Bone Marrow Failure Syndromes: Conditions like aplastic anemia or leukemia can cause thrombocytopenia due to bone marrow failure or infiltration.
Rare Diagnoses
- Wiskott-Aldrich Syndrome: A rare X-linked recessive disorder characterized by thrombocytopenia, eczema, and recurrent infections due to immunodeficiency.
- Congenital Thrombocytopenias: A group of rare disorders that present with thrombocytopenia at birth, often associated with other physical anomalies or syndromes.
- Kasabach-Merritt Syndrome: A rare condition characterized by thrombocytopenia and consumption coagulopathy associated with a vascular tumor, typically a kaposiform hemangioendothelioma.