Clinico-etiological profile in patients of thrombocytopenia
Author(s): Dr. Raman Sharma, Dr. Ghritachi Sandal and Dr. Ajay Chhabra
Abstract:Introduction: Thrombocytopenic patients in the hospital suffer a twofold greater mortality rate than those who are not. The etiologies of thrombocytopenia are diverse. Various studies on thrombocytopenia are done in the past have related to specific etiologies. But, in India there is lack of extensive researches which covers wide etiological spectrum of thrombocytopenia.
Aim: To study the clinico-etiological profile in patients of thrombocytopenia prevalent in our region.
Methods: This Cross Sectional study was conducted on 100 patients with thrombocytopenia attending outdoor department or admitted in Medicine Department of Guru Nanak Dev Hospital, attached to Government Medical College Amritsar. The study required these routine investigations. Baseline platelet counts were done on the day of admission repeated on alternate days until normal or near normal platelet count reached. On the basis of platelet count, mild thrombocytopenia was considered if platelet counts4 were >70 × 103/µL, moderate if platelet counts were between 20-70 × 103/µL and severe if platelet counts were <20 × 103/µL.
Results: Based on platelet count, among 100 study cases mild thrombocytopenia was observed in 52 (52%) cases, moderate thrombocytopenia in 44 (44%) cases and severe thrombocytopenia in 4 (4%) cases. Fever was the most common clinical symptoms in patients with thrombocytopenia and splenomegaly was the most common signs. 36% of total thrombocytopenia cases presented with bleeding manifestations. The common etiologies of thrombocytopenia in our study were dengue fever, megaloblastic anemia, cirrhosis and enteric fever. Mild thrombocytopenia was more prevalent in 41-50 year males and moderate thrombocytopenia in 31-40 year males while 41-50 years females presented more with severe thrombocytopenia. Presenting complaints were splenomegaly and petechiae in mild to moderate thrombocytopenia groups. While, hepatomegaly and gross bleed in the form of hematuria were the presentations in the severe thrombocytopenia group.
Conclusion: The etiology of thrombocytopenia is seen to vary geographically and seasonally which contribute to significant morbidity and mortality. Prompt diagnosis and immediate specific treatment of underlying etiology causing thrombocytopenia, with maintenance of platelet count and haemostatic function gives good recovery.