My patient is thrombocytopenic! Is (s)he? Why? And what shall I do?

Summary

Solving the riddle of a thrombocytopenic patient is a difficult and fascinating task. The spectrum of possible aetiologies is wide, ranging from an in vitro artefact to severe treatment-resistant thrombocytopenic bleeding conditions, or even life-threatening prothrombotic states. Moreover, thrombocytopenia by itself does not protect from thrombosis and sometimes a patient with a low platelet count requires concomitant antithrombotic treatment as well. In order to identify and treat the cause and the effects of the thrombocytopenia, you have to put together several pieces of information, solving a unique jig-jaw puzzle.

The present work is not a textbook article about thrombocytopenia, rather a collection of differential diagnostic thoughts, treatment concepts, and some basic knowledge, that you can retrieve when facing your next thrombocytopenic patient. Enjoy reading it, but most importantly enjoy taking care of patients with a low platelet count. I bet the present work will assist you in this challenging and rewarding clinical task.

Zusammenfassung

Das Rätsel eines thrombozytopenischen Patienten zu lösen, ist eine schwierige und faszinierende Aufgabe. Das Spektrum der möglichen Ätiologien ist breit und reicht von einem In-vitro-Artefakt bis zu behandlungsresistenten thrombozytopenischen Blutungen oder sogar zu lebensbedrohlichen prothrombotischen Zuständen. Außerdem schützt eine Thrombozytopenie an sich nicht vor Thrombosen und manchmal bedarf ein Patient mit niedriger Plättchenzahl auch einer begleitenden antithrombotischen Therapie. Um die Ursache und Effekte der Thrombozytopenie zu identifizieren und zu behandeln, sind unterschiedliche Informationen zusammenzufügen, damit das einmalige Puzzle des Patienten gelöst werden kann.

Diese Arbeit ist kein Lehrbuchartikel über Thrombozytopenie, eher eine Sammlung von differenzialdiagnostischen Gedanken, Behandlungskonzepten und einigen Grundlagen, die Sie abrufen können, wenn Sie den nächsten thrombozytopenischen Patienten begegnen. Genießen Sie das Lesen und freuen Sie sich vor allem, Patienten mit niedriger Plättchenzahl zu betreuen. Ich wette, dass diese Arbeit Sie bei der anspruchsvollen und dankbaren klinischen Aufgabe unterstützt.

Keywords

Thrombocytopenia

Schlüsselwörter

Thrombozytopenie

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