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Selected causes of thrombocytopenia are shown in Table 14–2. The age of the patient and presence of comorbid conditions can help direct the diagnostic workup.

Table 14–2.Selected causes of thrombocytopenia.

The risk of clinically relevant spontaneous bleeding (including petechial hemorrhage and bruising) does not typically increase appreciably until the platelet count falls below 10,000–20,000/mcL, although patients with dysfunctional platelets or local vascular defects can bleed with higher platelet counts. Suggested platelet counts to prevent spontaneous bleeding or to provide adequate hemostasis around the time of invasive procedures are found in Table 14–3. However, most medical centers develop their own local guidelines to have a consistent approach to such complex situations.

Table 14–3.Desired platelet count ranges.

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