Thrombocytopenia, A Comprehensive Study of Causes, Diagnostic Approaches, and Therapeutic Options
1Dr Khizar Abdullah Khan, 2Kazim Rodi Raja, 3Faiza Maqsood, 4Mansoor Musa, 5Qasim Raza, 6Dr.Huma Riaz
Submission: 11 January 2026 | Acceptance: 28 January 2026 | Publication: 02 March 2026
1Lady Reading Hospital/MTI, Peshawar
3PIMs, Islamabad
4Mayo Hospital, Lahore
5Sir Gangaram Hospital, Lahore
6Associate professor Hematology MBBS DCP, FCPS Hematology Hayatabad Medical Complex MTI Peshawar
Correspondence Author: Dr.Huma Riaz,Associate professor Hematology MBBS DCP, FCPS Hematology Hayatabad Medical Complex MTI Peshawar
Abstract
Background
Thrombocytopenia, explained a platelet count below 150 × 10⁹/L, is a frequent hematological abnormality with complex etiologies. Its clinical scope ranges from incidental findings to life-threatening hemorrhage. International societies, which includes the BSH, ISTH, and ASH, highlight systematize diagnostic methods and evidence-based treatment techniques.
Objectives
To review the major causes, diagnostic methods, and treatment techniques for thrombocytopenia, while consolidating recommendations from BSH, ISTH, and ASH instructions.
Methods
A systematic literature searches from 2000 to 2024 was held by using PubMed, Embase, and Cochrane databases. Articles were assessed according to GRADE methodology, lined up with the foundation of BSH, ISTH, and ASH. Evidence was synthesized into diagnostic and therapeutic recommendations.
Results
Thrombocytopenia emerge from decreased platelet production, increased destruction, splenic sequestration, or other dilutional effects. Immune thrombocytopenia is the most frequent earned cause, while bone marrow failure syndromes are major causes of production failure. Diagnostics include CBC, peripheral smear, bone marrow biopsy, and immune or viral testing. Treatment differ by etiology and severity: corticosteroids and IVIG are first-line for ITP, while extreme bleeding needs platelet transfusion.
Conclusion
International instructions agree that diagnosis of thrombocytopenia must accompany a structured approach, with treatment modified to cause and severity. Advances includes thrombopoietin receptor agonists and shared decision-making models improve long-term management.
Keywords: Thrombocytopenia; Diagnosis; Immune Thrombocytopenia; Platelet Disorders; Guidelines