Peripheral Blood Findings in Thrombocytopenic Disorders
Finding | Disorders |
|---|---|
Normal red blood cells (RBCs) and white blood cells (WBCs) | Drug-induced thrombocytopenia Hepatitis C–related thrombocytopenia HIV-related thrombocytopenia Posttransfusion purpura |
RBC fragmentation (schistocytes) | Disseminated intravascular coagulation (DIC) HELLP syndrome (hemolytic anemia, elevated liver enzymes, low platelets) Metastatic cancer to the bone marrow (ie, myelophthisis) Preeclampsia with DIC Thrombotic thrombocytopenic purpura Valvular hemolysis |
WBC abnormalities | Hypersegmented polymorphonuclear leukocytes in megaloblastic anemias Atypical lymphocytes in large granular lymphocyte leukemia or increased mature lymphocytes in chronic lymphocytic leukemia Markedly diminished granulocytes in aplastic anemia Blasts and other immature cells in acute leukemia (myeloid/lymphoblastic/mixed phenotype) |
Frequent giant platelets (approaching the size of RBCs) | Bernard-Soulier syndrome Disorders related to the myosin heavy chain 9, non-muscle gene (MYH9) Other congenital thrombocytopenias Myelodysplastic syndrome (MDS) |
RBC abnormalities, nucleated RBCs, and immature granulocytes | Myelofibrosis Metastatic cancer to the bone marrow (ie, myelophthisis) |
Platelet clumping | Pseudothrombocytopenia |
