ALGORITHM FOR THROMBOCYTOPENIA EVALUATION

Platelet count <

150.000/L
Hemoglobin and white
blood count
Abnorm
al

Normal

Peripheral
blood
Normal RBC
morphology;
platelets normal or

Bone marrow
examination
Platelets clumped:
Redraw in sodium

Fragmented
red blood

Consider:
Drug-induced
thrombocytopenia Infectioninduced thrombocytopenia
Idiopathic immune
Algoritma evaluasi pasien trombositopenia

Alogaritma lain evaluasi pasien trombositopenia

Microangiopathic
hemolytic anemias

Thrombocytopenia:
Platelet count <
Examine
smear

Look for specific diagnostic clues on the peripheral blood smear

Nondiagnosti
c
Schistocy
tes

Isolated
thrombocytopenia
Yes

N
o

Confirm hemolysis: LDH

bilirubin

Recent
Yes

N
o

ITP
Drug
induced

Positiv
e

Negativ
e

Suspicious for
primary marrow
disorder

Direct
Coombs

Chemotherapy
-induced
thrombocytop

Spherocy
tes

Nucleated red
cells
Bilobed
neutrophils
Bone
marrow

DIC
Panel
Negati
ve
TTPHUS

Alogaritma lain evaluasi pasien trombositopenia

Positiv
e
DIC

Evan
Syndrome

Platele
t
Artifactual
thrombocytop
Hereditary
thrombocytop

Primary Marrow
Disorder
MDS
Lymphoma
Myeloma
Leukemia
Aplastic anemia

Giant
platelets

Sumber : CDK-217/vol.41 no.6,th.2014

Alogaritma lain evaluasi pasien trombositopenia