Thrombocytopenia and platelet transfusion

Thrombocytopenia is caused by disorders impairing platelet production, causing platelet destruction, or leading to platelet sequestration. Hematologic malignancies including the myeloproliferative disorders may result in marked splenomegaly. Thrombocytopenia is also a side effect of the cytotoxic chemotherapy administered for many different hematologic and nonhematologic malignancies. Heparin-induced thrombocytopenia is a special type of immune mediated thrombocytopenia. Posttransfusion purpura is a rare but serious complication of blood transfusion, characterized by the sudden onset of severe thrombocytopenia usually within 5-10 days of a blood transfusion. Prophylactic transfusion refers to the maintenance of the platelet count above a certain threshold in patients who are neither bleeding nor actively consuming platelets because of immune destruction or infection. Reviews of the literature have been performed of the risk of spinal hematoma following lumbar puncture or neuraxial anesthesia. The appropriate investigation and management of platelet refractoriness require consideration of information from a clinical assessment of the patient as well as laboratory investigations.