Summary Writer: Nicholas Malouf
Editor: Shafqat Inam
Interviewee: Shafqat Inam
James talks to Dr Shafqat Inam about thrombocytopaenia.
Shafqat Inam is currently a Haematology registrar at Royal Prince Alfred and Concord Hospitals, and Associate Lecturer at the University of Sydney. He studied medicine at the University of New South Wales and completed his junior medical officer and basic physician training at Royal Prince Alfred Hospital. Shafqat has a particular interest in research and medical education.
With Dr Shafqat Inam, Haematology Registrar at Royal Prince Alfred and Concord Hospitals, New South Wales, Australia
Thrombocytopaenia (low platelet count) is a common finding amongst inpatients and may occur due to a range of factors. It is often picked up incidentally as well as in the context of bleeding. A normal platelet count is 150 – 400 x 109/L. Degrees of thrombocytopaenia: mild 100 – 150 x 109/L; moderate 50 – 100 x 109/L; and severe< 50 x 109/L. The risk of severe spontaneous bleeding is greatly increased with platelets< 20 x 109/L. Evaluation of the patient with thrombocytopaenia ought to address both complications from low platelets and the aetiology of the condition.
Case 1 – A patient was admitted overnight via the Emergency Department with fever on a background of prosthetic valve, IVDU and alcohol dependence. Their platelet count on admission was 40 (x109/L).
Case 2 – A 26 year old female presents to the Emergency Department with petechiae on the shins, ankles and feet. Further history reveals recent easy bruising and menorrhagia. The platelet count is 12 x 109/L but WCC and Hb are normal.
Case 3 – A 72 year old maleis day 8 post elective coronary artery bypass grafting for coronary artery disease. He is on twice daily heparin for DVT prophylaxis. His platelet count has dropped to 80 from 190 pre-op. His left calf is swollen compared to the right.
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