Thrombocytopenia

1. Identify underlying cause (e.g.immune-mediated, infectious, neoplasia, drag-induced, etc.) and treat as appropriate.

2. Use L-thyroxine therapy at 0.1 mg per 10 pounds body weight twice daily for 7-10 days. Start 48 hours prior to elective surgery where applicable. Continue thyroid replacement if patient is still bleeding or has thyroid
disease. Thyroid supplementation promotes hemostasis by improving platelet function, stimulating thrombopoiesis in bone marrow and other sites, and enhancing protein synthesis of von Willebrand factor and other coagulation

 3. For patients with PCV at or below 15%, transfuse Packed Red BloodCells in saline at 3-5 ml per pound (or equivalent volumes of fresh whole blood) given once or twice daily. There are insufficient numbers of platelets in freshly collected whole blood to achieve hemostasis in sever thrombocytopenia or thrombopathia (platelet dysfunction). However, the plasma component and platelets present can provide some thrombopoietic and hemostatic benefit to sustain the patient until the underlying problem and requisite therapy have been managed.

4. For control or prophylaxis m special situations of severe, chronic thrombocytopenia (e.g. oncology patients on chemotherapy) or acute life-threatening bleeding. from thrombocytopenia,. fresh Platelet-Rich Plasma (PRY) can be provided. This treatment is not recommended routinely for immune thrombocytopenia as platelets are rapidly destroyed. Repeated use of PM' is not advised as immune sensitization (alloimmunization) to platelets and white blood cells is likely to develop. To reduce all oimmunization, PRP should be processed after collection through aspecial filter set that removes most of the white blood cells. Only filtered PR') should be used for sustaining the platelet needs of chemotherapy or other patients with severe platelet disorders.