Thrombocytopaenia Differential

Diagnostic Algorithm: Systematic triage of low platelets. Always rule out clumping (Pseudothrombocytopenia) and fragmentation (TMA) first.

1. Rule out Artifacts

Does the blood film show platelet clumping, or are there giants platelets in an EDTA sample?

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Systematic diagnostic workup for an unexpected low platelet count.

Differentiating common causes (ITP, Gestational) from rare/emergent causes (TMA, TTP).

Interpreting laboratory markers like MPV and IPF in the context of thrombocytopenia.

The First Step

Always rule out "Pseudothrombocytopenia" (platelet clumping in EDTA) by examining the peripheral blood film or repeating the draw in a Citrate or Heparin tube.

How it Works

Diagnostic Branches

Mechanism	Lab Clues	Common Causes
Production Failure	Low IPF, Low Retics, Macro- or Microcytosis	MDS, B12/Folate deficiency, Chemotherapy, Alcohol
Increased Destruction	High IPF, High MPV, Healthy RBCs	ITP, Drug-induced (Heparin/DITP), Gestational
Consumption / TMA	Schistocytes on film, High LDH, Low Haptoglobin	TTP, HUS, DIC, HELLP Syndrome
Sequestration	Splenomegaly on exam/imaging	Portal Hypertension (Cirrhosis), Myelofibrosis

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

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Clinical Context

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Clinical Context

We think this has broad domain relevance to Thrombocytopaenia Differential & Algorithm.

Thrombocytopaenia Differential

1. Rule out Artifacts

When to Use

When to Use

The First Step

How it Works

Diagnostic Branches

Clinical Pearls

IPF Usage

The 'Sick' Film

The Evidence

Primary Strategy

A systematic approach to the diagnosis of thrombocytopenia.

Origins & History

Consensus

Recent Journal Updates

Thrombocytopaenia Differential

1. Rule out Artifacts

When to Use

When to Use

The First Step

How it Works

Diagnostic Branches

Clinical Pearls

IPF Usage

The 'Sick' Film

The Evidence

Primary Strategy

A systematic approach to the diagnosis of thrombocytopenia.

Origins & History

Consensus

Recent Journal Updates