Abstract

Background: The etiologies of thrombocytopenia are diverse. Various studies on thrombocytopenia are done in the past have related to specific etiologies. Objectives:ThisstudyattemptstodeterminethecommonetiologiesofthrombocytopeniainadultpatientsadmittedtoCivil Hospital, Ahmedabad. Material and Methods: A cross-sectional study was carried out at Civil Hospital, Ahmedabad. Patients with thrombo- cytopenia more than 18 years of age at admission between 1 October and 31 October 2013 were followed up during their stay inhospital, diagnosis were made, and bleeding manifestations andrequirement of platelet transfusion were recorded.
Results:Fromthe412patientsstudied,denguewasdiagnosedin28.6%ofpatientsfollowedbymalariain22.8%,chronic liver disease in 15.2%, hypersplenism in 12.3%, septicemia in 6.3%, gestational thrombocytopenia and disseminated intravascularcoagulationin5.5%,immunethrombocytopenicpurpura(ITP)in3.1%,megaloblasticanemiain1.9%,human immunodeficiencyvirus in 1.4%,drug-inducedthrombocytopenia in1.2%,leukemiain 0.7%,andaplasticanemiain0.48%. Bleedingsecondarytothrombocytopeniawasseenin46(11.2%)patients;ofthem,28werediagnosedwithdenguefever,4 with chronic liver disease, 3 with sepsis, 2 with hematological malignancies, and 9 with ITP. The common bleeding manifestations were gum bleed, purpura, petechial rash, and bruising. All the cases with platelet counto5,000/mL had bleeding manifestations secondary to thrombocytopenia. From the patients studied, 79.3% had fever associated with thrombocytopenia.Platelettransfusionwasgivento87patients:ofthese,46(52.8%)weretransfusedbecauseofbleeding and 41 (47.1%) were given prophylactic transfusion. Conclusion: Dengue fever was the most common cause of thrombocytopenia and the most common etiology found in patients who had bleeding secondary to thrombocytopenia with gum bleed as a common manifestation. There was no definitive trigger value of platelet for platelet transfusion, and transfusion because of bleeding and prophylactic transfusion were given in almost similar proportions of patients.