Lab Medicine Edition | CBC: Platelets (Thrombocytosis, Thrombocytopenia)
May 9, 2024
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Dr. Ronald S. Go discusses abnormal platelet test results and their implications on patient care. Topics include the differentiation between reactive and primary causes of elevated platelet counts, diagnostic considerations post-transfusion, detecting platelet clumping in blood samples, differentiating serious platelet disorders, and advancements in platelet apheresis.
Platelet counts above 350 raise concerns, with levels over 600 considered significant, and counts exceeding 1,000 signal immediate attention.
A platelet count below 100 warrants closer examination, as isolated thrombocytopenia may stem from production, destruction, or hypersplenism issues.
Deep dives
Understanding Platelet Counts in CBC
Elevated platelet counts above 350, with readings outside the reference range, may cause concern, especially if reaching 600 or higher. Concern heightens significantly if counts surpass 1,000. Reactive causes are common culprits, with primary causes being less frequent. Inflammatory conditions, infections, or cancer-related factors often contribute to reactive elevation.
Assessing Platelet Counts for Outpatient Providers
For outpatient clinicians observing platelet counts around 650,000, a cautious approach suggests rechecking the count to gauge consistency. Persistent elevations post-repeat tests might prompt further investigations like mutation testing. Setting thresholds for immediate action peg counts above 1,000 as signals demanding prompt attention.
Navigating Low Platelet Counts and Diagnostic Considerations
Low platelet counts above 100 may not warrant immediate concern, but counts under 100 suggest a closer look. Isolated thrombocytopenia often stems from production, destruction, or hypersplenism issues. Rule-outs for production problems include nutritional deficiencies or drug side effects, while destruction may hint at immune-mediated issues such as ITP or non-immune causes like TTP.
Join our host, Andy J. Herber, P.A.-C., as he discusses the complete blood count (CBC), which is one of the most ordered laboratory tests in the primary care setting. Providers are frequently tasked with evaluating all aspects of the CBC. A keen understanding of this laboratory test is essential to providing quality care for patients. Ronald S. Go, M.D. returns as a guest to discuss abnormal platelet test results and its implication on patient management.