Author(s): C. Kumaran1
Thrombocytopenia is one of the relatively common finding in haematological investigation. The causes of this varies from mild cases, viral fever to malignant conditions like leukaemia. Though abnormal platelet count is detected by automatic haematology analyser, confirmation is always done by peripheral smear examination.
2156 patients’ blood samples from OPD and inpatients are collected in CBC tubes and subjected to automatic haematology analyser (SYSMEX KX-21) and the results were analysed. In all these cases of low platelet count, repeat analysis was done with suitable anticoagulant 3.8% sodium citrate, finally smear examination was done as a confirmatory evidence.
256 cases of thrombocytopenia were encountered out of 2156 patients’ samples. It accounted for 11.8% of blood samples that were run on the analyser. Age varied from 0-75 years with peak incidence in 15-30 years. It is seen more among males than females. In our study, viral infection, dengue fever formed the commonest cause and seen with peak incidence in rainy season from June to October. Rarer cases seen were leukaemia, hypersplenism and massive blood transfusion. Majority of the cases were presented with mild-to-moderate thrombocytopenia. Only 19% cases presented with severe thrombocytopenia (counts less than 40,000 cells per cu. mm).
An important approach to the diagnosis and successful treatment of thrombocytopenia is understanding the underlying pathophysiological process in the development of disease. Prompt investigations and identification may be crucial and sometimes lifesaving as in TTP, HIT or severe ITP.
Notable progress has been made in the recent years in developing new treatment option for thrombocytopenia like ITP. Early diagnosis, treatment, vector control, community awareness are essential to decrease the incidence thrombocytopenia.