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Diagnosis of thrombocytopenia
Investigation usually starts with asking the person for their history of symptoms, signs of bleeding or bruising, other medical problems, recent infections, medications (prescribed and bought over the counter). In addition to a complete medical history and physical examination, laboratory testing of the blood can show decreased platelet counts. Your doctor will begin by asking you about your medical history. In the haematology laboratory the laboratory technicians and the doctors perform a full blood count and examine the blood film under a microscope as well as the sample in the test tube. Having a blood sample taken and counting the platelets present in the sample would diagnose thrombocytopenia. Your physician will ask whether you recently have had any medical procedures or received any blood transfusions and whether you are taking any medications. Once a low platelet count is verified, a careful evaluation of the function of the bone marrow and spleen are necessary. A repeat full blood count sample is usually requested to confirm the result and see if it is a persisting abnormality. However, accurately determining the medical reason for this conditions is complex. Your doctor also may ask about how much alcohol you drink and your diet. Depending upon both the severity of the platelet lack and the likely cause, the person is likely to be referred to a haematologist at the hospital. You also will be asked questions to determine whether you are at risk of AIDS, including where and when you've had blood transfusions, about your sexual practices, whether you have ever used intravenous drugs, and whether you could have been exposed to infectious blood or bodily fluids at work. If the platelet count is very low the person may need to be seen on the same day, and have a bone marrow test performed. Improper functioning of either or both of these organs can cause thrombocytopenia. If you are pregnant, your physician will want to know your due date. A bone marrow test is usually done under local anaesthetic - the samples are usually taken from the back of the pelvis. This test helps the haematologist to decide if platelets are being produced normally and whether the rest of the bone marrow appears normal.
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