An HIV-positive patient may develop thrombocytopenia in a number of ways.



bone marrow suppression related to advanced HIV disease (HIV-associated thrombocytopenia)

AIDS with exclusion of other conditions, remits on therapy with zidovudine

disseminated infection affecting the bone marrow (histoplasmosis, tuberculosis, etc)

positive bone marrow cultures; organisms seen on bone marrow biopsy

malignant lymphoma or other tumor involving the bone marrow

bone marrow involvement

immune thrombocytopenic purpura (ITP)

anti-platelet antibodies

drug-induced thrombocytopenia

temporal appearance related to drug therapy; remits on stopping drug

HIV-related TTP/HUS

microangiopathic hemolytic anemia; abnormality ADAMTS13; preceding infection with E. coli 0157


significant splenomegaly

disseminated intravascular coagulation (DIC)

positive fibrin split products, hypofibrinogenemia

aplastic or hypoplastic marrow

absent or reduced megakaryocytes in bone marrow biopsy


A patient may have more than one of these conditions.


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