Thrombocytopenia in Hospitalized Patients

Thrombocytopenia is one of the most commonly encountered problems by inpatient hematologic consultants. In the hospital, thrombocytopenia may vary in importance from a curious epiphenomenon commanding no special attention to a critical clue to a life-threatening blood disorder that requires specialized treatment. The disorders encountered, and the approach to them, differ distinctly from thrombocytopenic disorders seen in the outpatient clinic.

Dr. Marie Scully will provide an approach for distinguishing between different thrombotic microangiopathies, all serious disorders with some common features, yet distinct and requiring quite different therapeutic interventions to accomplish favorable outcomes. Dr. Scully will also provide an update on the latest concepts emerging in this fast-moving field.

Dr. Ryan Zarychanski will review the multiple disorders and underlying mechanisms that lead to thrombocytopenia in one-third to one-half of intensive care unit patients. He will show how trends in platelet count can inform both diagnosis and prognosis. The newest transfusion guidelines and their evidence base will be discussed.

Dr. Lawrence Rice will review the clinical features of heparin-induced thrombocytopenia by briefly tracing the evolution of our understanding. Emphasis will be on diagnosis, when to suspect the disease, when to order serologic tests, and how to interpret them, stressing that it is not only important not to miss the problem but also not to contribute to the epidemic of harmful over-diagnosis.