Bone Marrow Examination in Thrombocytopenia

Dr Narender TejwaniWritten by | HAEMATOLOGY

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Immune thrombocytopenia (ITP) is characterized by the presence of peripheral destruction of platelets due to presence of circulating antiplatelet antibodies
While diagnosing, “Bone Marrow Examination” is one of the most controversial investigation in patients having isolated thrombocytopenia.
The general agreement is that in children with typical features suggestive ITP with no abnormal finding on routine investigations bone marrow examination is not required. However due to lack of standardization across the country a bone marrow is required in all adult patients with ITP. If any abnormal finding suggestive of an alternative diagnosis is there than bone marrow should be done. Bone marrow is also indicated in all patients who are steroid resistant or undergoing splenectomy for confirmation of diagnosis. Typical bone marrow finding in a case of ITP includes the presence of a cellular bone marrow with usually increased or normal megakaryocytes with presence of young forms (Megakaryocytic Thrombocytopenia). Erythroid hyperplasia may be found secondary to bleeding. One should rule out presence of significant dysplasia, atypical cells or marrow infiltration by lymphoma or non hematological malignancies.

Last modified: 13/06/2017

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