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Hematology focuses on diseases of the blood, bone marrow, and lymphatic system. Learn about the diagnosis and treatment of anemia, leukemia, and lymphoma.
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Diagnosing thrombocytopenia is a deductive process. It begins with identifying the low count and then systematically ruling out causes to find the origin—whether it is a production problem, a destruction problem, or a trapping problem. At Liv Hospital, our diagnostic pathway is designed to be thorough yet efficient, minimizing invasive tests while ensuring that critical underlying conditions like leukemia or liver disease are not missed.
The diagnosis is almost always established with a simple blood test called a Complete Blood Count.
This test uses an automated machine to count the number of red cells, white cells, and platelets in a sample.
It establishes the severity of the condition.
The CBC also reveals if other cell lines are low. If red and white cells are also low (pancytopenia), it suggests a bone marrow failure issue rather than simple destruction.
A drop of blood is smeared on a glass slide, stained, and examined under a microscope by a pathologist.
This is essential to rule out pseudothrombocytopenia, where platelets stick together in the test tube, fooling the machine counter.
The size and shape of the platelets provide clues. Large, young platelets (giant platelets) suggest the marrow is healthy and trying hard to compensate for destruction (as in ITP). Small or pale platelets might suggest a production defect.
The presence of fragmented red blood cells (schistocytes) is a red flag for thrombotic microangiopathies like TTP or HUS, which are medical emergencies.
If the cause is unclear, or if there are signs of marrow failure, a biopsy is performed.
A needle is used to withdraw liquid marrow from the hip bone.
A small core of solid bone tissue is removed.
Tests such as PT (Prothrombin Time) and aPTT (Activated Partial Thromboplastin Time) measure how long it takes blood to clot.
These tests are usually normal in simple thrombocytopenia. If they are prolonged, it suggests a problem with the clotting proteins in the plasma, pointing towards liver disease or disseminated intravascular coagulation (DIC).
Blood tests are run to look for infections or immune markers.
Testing for HIV, Hepatitis C, and Epstein Barr Virus is routine, as treating the virus often cures the platelet problem.
Tests for ANA (Anti Nuclear Antibody) can detect lupus. Specific tests for anti platelet antibodies exist but are rarely used because they are not always accurate for diagnosis.
Imaging helps evaluate the spleen and liver.
An abdominal ultrasound is the standard tool to check for splenomegaly (enlarged spleen). An enlarged spleen suggests sequestration (trapping) or liver disease. A normal sized spleen is typical for ITP.
This may be used if lymph nodes are enlarged or if an internal tumor is suspected.
Infection with H. pylori, the bacteria that causes ulcers, has been linked to ITP.
Testing for this bacteria is part of the standard workup in many regions. Eradicating the bacteria with antibiotics can sometimes improve platelet counts.
Levels of Vitamin B12 and Folate are measured. Deficiencies in these vitamins cause megaloblastic anemia, which can lead to low production of all blood cell types.
Send us all your questions or requests, and our expert team will assist you.
It involves a quick needle stick in the arm, which feels like a pinch. The pain is minimal and brief.
It is a test where a doctor looks at your blood cells under a microscope to see their shape and size, and to check for clumping.
low, a biopsy lets doctors look directly inside the bone marrow to see if it is making cells correctly.
No, an ultrasound pictures organs. It is used to see if your spleen is enlarged, which is a common cause of low platelets.
It is a young, newly made platelet that is larger than normal. Seeing them is actually a good sign that your bone marrow is working hard to replace missing platelets.
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