spontaneous bleeds may occur when count between 20 - 50 000 per cubic mm
serious bleeding more likely if the count drops below 20 000 per cubic mm
platelets may be enlarged - megathrombocytes - produced in response to enhanced destruction.
bone marrow - normal or increased megakaryocytes - there are no other abnormalities. Bone marrow investigation is mandatory if steriods are to be given, to rule out leukaemia.
PT, PTT and coagulation time are normal
if haemorrhage occurs then there is:
increased WBC with shift to left
anaemia - reticulocytes
tests for platelet associated IgG - 95% sensitivity, 50% specificity for increased platelet IgG due to thrombocytopenia
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