Authentic and Spurious Causes of Thrombocytopenia

Author: Betty Ciesla MS, MLS(ASCP)SH
Reviewers: Laurie Bjerklie, MA, MLS(ASCP)CM and Barbara Caldwell, MS, MLS(ASCP)SH
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Hematology): 1 hour(s)

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Platelets are the first responders to a bleeding incident. If the full platelet force does not arrive on the scene, bleeding will continue, and petechiae, bruises, and perhaps even hemorrhaging will occur. A decreased platelet force (thrombocytopenia) may be caused by several diseases or disorders. On the other hand, a low platelet count may not necessarily mean that the full platelet response is unavailable. It is up to the laboratory professional to determine whether anything in the collection procedure has artificially produced this low count. This course will increase your understanding of various authentic causes of thrombocytopenia and will alert you to various causes of spurious thrombocytopenia that you, as a medical laboratory professional, should be able to recognize and correct to prevent false reporting of thrombocytopenia.

Objectives

  • Define thrombocytopenia.
  • Recognize clinical signs that are associated with thrombocytopenia.
  • Identify conditions that cause the destruction of platelets.
  • Describe current treatments for various conditions that cause thrombocytopenia.
  • Identify conditions that cause decreased platelet production.
  • Recognize and correct falsely decreased platelet counts.

Course Outline

  • Introduction
    • Definition of Thrombocytopenia
    • Signs Associated with Thrombocytopenia
    • Which of the following is a clinical sign that is associated with thrombocytopenia?
  • Conditions Causing Increased Destruction and Consumption of Platelets
    • Increased Platelet Destruction
  • Immune Thrombocytopenic Purpura
    • Immune Thrombocytopenic Purpura
    • Acute Immune Thrombocytopenic Purpura
    • Chronic Immune Thrombocytopenic Purpura
    • Thrombocytopenia in Neonates
    • Treatment for ITP
    • Match each of the statements listed below with the type of ITP with which it is most closely associated.
  • Drug-Induced Thrombocytopenia
    • Drug-Induced Thrombocytopenia
    • Pathophysiology of Heparin-Induced Thrombocytopenia
    • Additional Complications Related to Heparin-Induced Thrombocytopenia
    • True or False: When heparin-induced thrombocytopenia occurs, the platelet count noticeably decreases immediately after heparin treatment begins.
  • Thrombotic Thrombocytopenic Purpura and Hemolytic Uremic Syndrome
    • Microangiopathic Hemolytic Anemia
    • Thrombotic Thrombocytopenic Purpura
    • Hemolytic Uremic Syndrome
    • Laboratory Findings
    • Which of the following bacteria is often linked to diarrhea-associated hemolytic uremic syndrome?
    • Treatment of TTP
    • Treatment of HUS
  • Disseminated Intravascular Coagulation
    • Disseminated Intravascular Coagulation
    • Clinical Signs and Symptoms
    • Laboratory Findings
    • Treatment of DIC
    • Which of the following laboratory results would you find with disseminated intravascular coagulation (DIC) but not with thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome (HUS)?
  • Conditions Causing Decreased Platelet Production
    • Impaired Platelet Production Disorders
    • True or False: Patients undergoing chemotherapy treatments will have deficiencies in platelet numbers as well as red and white blood cells.
    • With which of these conditions or procedures may there be an increased number of megakaryocytes in the bone marrow but a decreased number of circulating platelets?
  • Other Causes of Thrombocytopenia
    • Increased Splenic Sequestration and Thrombocytopenia
    • Dilutional Thrombocytopenia
  • Variables Causing False Thrombocytopenia
    • Pre-Examination Variables Leading to False Thrombocytopenia
    • Pseudothrombocytopenia: Platelet Satellitism and Platelet Clumping
    • Importance of Addressing Platelet Variables
    • Which of these conditions is associated with a pseudothrombocytopenia?
  • References
    • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Betty Ciesla, MS, MLS(ASCP)SH, is a faculty member at Morgan State University in Maryland. She holds an MS degree in Biomedical Communication. She has presented at national workshops in Hematology and Coagulation, authored several book chapters and articles on topics in Hematology, and served on the ASCP’s Tech Sample Committee, Education Program Committee, and, most recently, the Hematology Examination Committee.
The author has no conflict of interest to disclose.
Reviewer Information:  
Laurie Bjerklie, MA, MLS(ASCP)CM, is a Lead Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.
Barbara Caldwell, MS, MLS(ASCP)SH, is the administrative director of clinical laboratory services at Montgomery General Hospital in Olney, Maryland. She is also an experienced educator, having served as a Clinical Assistant Professor at the University of Maryland School of Medicine in the Department of Medical and Research Technology. Ms. Caldwell holds an MS degree from the University of Maryland School of Medicine. She has authored numerous textbook chapters, articles, and abstracts related to topics in Hematology.