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Laboratory features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The laboratory features of ITP include:

  • thrombocytopenia:
    • platelet count less than 100 000 per cubic mm
    • no bleeding until less than 50 000 per cubic mm
    • 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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