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Updated: Jul 9, 2025

Microfluidics in Assessing Platelet Function
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Where have all the platelets gone? HIT, DIC, or something else?

Rohith Jesudas1, Clifford M Takemoto1

  • 1St Jude Children's Research Hospital, Memphis, TN.

Hematology. American Society of Hematology. Education Program
|December 9, 2023
PubMed
Summary

Diagnosing thrombocytopenia in ill children is crucial. This review focuses on consumptive causes, including immune and nonimmune triggers, essential for effective patient management.

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Area of Science:

  • Pediatric Hematology
  • Critical Care Medicine

Background:

  • Thrombocytopenia is common in ill children, posing diagnostic challenges for effective management.
  • Understanding accelerated platelet consumption mechanisms, including microvascular trapping and phagocytosis, is key.
  • Distinguishing immune from nonimmune consumptive thrombocytopenia is vital.

Approach:

  • This review focuses on consumptive thrombocytopenia in critically ill children.
  • It examines immune and nonimmune triggers and downstream platelet clearance mechanisms.
  • The review differentiates various thrombotic microangiopathy (TMA) syndromes and related conditions.

Key Points:

  • Thrombocytopenia with microangiopathic hemolytic anemia (MAHA) often indicates disseminated intravascular coagulation or TMA.
  • Specific TMA syndromes include thrombotic thrombocytopenic purpura, complement-mediated TMA, and Shiga toxin-mediated hemolytic uremic syndrome.
  • Immune thrombocytopenia, heparin-induced thrombocytopenia, antiphospholipid antibody syndrome, and hemophagocytic lymphohistiocytosis are discussed as causes of immune-mediated thrombocytopenia.

Conclusions:

  • Accurate diagnosis of thrombocytopenia etiology in ill children is essential for appropriate management.
  • Consumptive thrombocytopenia, driven by immune or nonimmune factors, requires careful differentiation.
  • This review provides a framework for understanding the complex causes of thrombocytopenia in pediatric critical care.