{"id":1333,"date":"2017-06-27T16:34:19","date_gmt":"2017-06-27T16:34:19","guid":{"rendered":"http:\/\/papergp.com\/index.php\/data-interpretation\/fbc-2\/platelets\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"platelets","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/data-interpretation\/fbc-2\/platelets\/","title":{"rendered":"Platelets"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Low platelets<\/h4>\n<ul>\n<li>\u00a0Causes\n<ul>\n<li>Artefact &#8211; repeat with blood film<\/li>\n<li>Infection &#8211; EBV, HIV, Malaria, TB<\/li>\n<li>Medications &#8211; NSAIDs, Heparin, Digoxin, Quinine, Anti-Epileptics, Anti-Psychotics, PPIs<\/li>\n<li>Alcohol<\/li>\n<li>Malignancy<\/li>\n<li>Liver\/Renal disease<\/li>\n<li>Aplastic anaemia<\/li>\n<li>B12\/Folate deficiency<\/li>\n<li>Autoimmune\/ITP\/SLE<\/li>\n<\/ul>\n<\/li>\n<li>History:\n<ul>\n<li>Travel<\/li>\n<li>Drugs<\/li>\n<li>Alcohol<\/li>\n<li>Bleeding (bruising, GI, nose, gums, periods, post dental, joints)<\/li>\n<\/ul>\n<\/li>\n<li>Assess severity\n<ul>\n<li>100-150 x 109\/L\n<ul>\n<li>Repeat monthly<\/li>\n<li>Refer\n<ul>\n<li>progressive decrease<\/li>\n<li>Other FBC abnormalities<\/li>\n<li>Unwell<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>50-100 x 109\/L\n<ul>\n<li>Refer\n<ul>\n<li>persists &gt; 4weeks<\/li>\n<li>other cytopenias, splenomegaly, lymphadenopathy, pregnancy, upcoming surgery<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>&lt;50 x 109\/L\n<ul>\n<li>Refer (urgent outpatient)<\/li>\n<li>Refer (emergency &#8211; &lt; 20 or any bleeding)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<div class=\"content-box-blue\">\n<h4>Raised platelets<\/h4>\n<ul>\n<li>Causes\n<ul>\n<li>Primary\n<ul>\n<li>myeloproliferative disorder (likely if splenomegaly and &gt; 1000)<\/li>\n<\/ul>\n<\/li>\n<li>Secondary (more common)\n<ul>\n<li>Reactive &#8211; infection, inflammation, exercise, tissue damage, post surgery, haemolysis<\/li>\n<li>Bleeding &#8211; periods<\/li>\n<li>Malignancy &#8211; esp lung, endometrial, gastric, oesophageal, colorectal (LEGO-C)<\/li>\n<li>Hyposplenism<\/li>\n<li>Iron deficiency<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>History\/Examination\n<ul>\n<li>Neurological symptoms<\/li>\n<li>Lung &#8211; haemoptysis, SOB<\/li>\n<li>Endometrial &#8211; Vaginal discharge, macroscopic haematuria, PMB, low ferritin<\/li>\n<li>Gastro-oesophageal &#8211; dysphagia<\/li>\n<li>Colorectal &#8211; PR bleeding, weight loss<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4>Management of high platelets<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>FBC\/blood film, CRP, ferritin<\/li>\n<li>Weight diary<\/li>\n<\/ul>\n<\/li>\n<li>If asymptomatic, repeat after 4 weeks\n<ul>\n<li>&lt; 450 x 109\/L\n<ul>\n<li>No further action<\/li>\n<\/ul>\n<\/li>\n<li>&gt;450 x 109\/L\n<ul>\n<li>Refer\n<ul>\n<li>persistent<\/li>\n<li>&gt;600<\/li>\n<li>associated with other abnormalities<\/li>\n<li>consider urgent cancer of unknown origin clinic<\/li>\n<li>consider urgent CXR<\/li>\n<li>If &gt; 55yo, consider upper endoscopy, pelvic USS<\/li>\n<li>consider FIT<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Urgent referral\n<ul>\n<li>Bleeding<\/li>\n<li>Neurological symptoms<\/li>\n<li>&gt;1000 x 109\/L<\/li>\n<li>&gt;600 x 10 with thrombosis or high risk of thrombosis\/CVD<\/li>\n<li>Splenomegaly<\/li>\n<li>Other significantly abnormal FBC indices<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Low platelets \u00a0Causes Artefact &#8211; repeat with blood film Infection &#8211; EBV, HIV, Malaria, TB Medications &#8211; NSAIDs, Heparin, Digoxin, Quinine, Anti-Epileptics, Anti-Psychotics, PPIs Alcohol Malignancy Liver\/Renal disease Aplastic anaemia B12\/Folate deficiency Autoimmune\/ITP\/SLE History: Travel Drugs Alcohol Bleeding (bruising, GI, nose, gums, periods, post dental, joints) Assess severity 100-150 x 109\/L Repeat monthly Refer progressive &hellip; <a href=\"https:\/\/papergp.com\/index.php\/data-interpretation\/fbc-2\/platelets\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Platelets<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1301,"menu_order":5,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1333","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1333","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1333"}],"version-history":[{"count":5,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1333\/revisions"}],"predecessor-version":[{"id":2529,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1333\/revisions\/2529"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1301"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1333"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}