Thrombocytopenia

Question 1

What are the ranges for mild, moderate, and severe thrombocytopenia?

Answer 1

Mild 100,000-150,000/mm3

Moderate 50,000-99,000/mm3

Severe <50,000/mm3

Question 2

When can you suspect gestational thrombocytopenia in a pregnant woman?

Answer 2

Often - it’s the cause of thrombocytopenia in 75% of pregnant women

Suspect if: no prior hx of low platelets, occurrence in mid-second trimester or later, platelet count >75,000/mm3

Question 3

A patient comes to your office at 28 weeks of gestation for her 1-hour glucose tolerance test. A complete blood count is done at the same time. Her platelet count is 95,000/mm3. A repeat platelet count 6 weeks later is 92,000/mm3. She currently feels well with no recent illnesses. She is healthy and takes only a prenatal vitamin. Her initial prenatal laboratory results show a platelet count of 287,000/mm3. She has normal blood pressure and her urine dipstick test result is negative for protein. The most likely diagnosis is:

(A) preeclampsia
(B) gestational thrombocytopenia
(C) idiopathic thrombocytopenic purpura 
(D) drug-induced thrombocytopenia
(E) thrombocytopenia due to a viral illness

Answer 3

(B) gestational thrombocytopenia