1st order laboratory parameters – obligatory laboratory tests.
- Small blood count
- Thrombocytopenia:
- Leichtgradig (150.00–70.000/μl)
- Mittelgradig (70.000–20.000/μl)
- Severe (< 20,000/μl)
- Platelet morphology [immune thrombocytopenia (ITP): the few platelets are often enlarged; giant platelets (i.e. ≥ erythrocyte diameter): possibly also Bernard-Soulier syndrome (BSS): this involves poorer platelet binding to the damaged vascular endothelium].
- Thrombocytopenia:
- Differential blood picture
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Coagulation parameters – PTT, Quick
- Hemolysis signs – values such as LDH ↑ (lactate dehydrogenase), HBDH ↑ (hydroxybutyrate dehydrogenase), reticulocytes ↑, haptoglobin ↓ and indirect bilirubin ↑ indicating hemolysis (dissolution of red blood cells).
Laboratory parameters 2nd order – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.
- Electrolytes – calcium
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
- Pregnancy test (quantitative HCG).
- Plasma electrophoresis – for suspected hypergammaglobulinemia, cryoglobulinemia, paraproteinemia.
- Rheumatoid diagnostics – rheumatoid factor (RF), antinuclear antibodies (ANA), cyclic citrulline peptide antibodies (CCP-AK).
- Skin biopsy (tissue removal from the skin) – if vasculitis (vascular inflammation) is suspected.
- Bone marrow biopsy – for suspected aplastic anemia (form of anemia (anemia) caused by pancytopenia (reduction of all cell rows in the blood; stem cell disease) and a concomitant hypoplasia).
Note: An increased bleeding tendency exists when the platelet count is below 150,000/μl. Spontaneous skin bleeding may occur at platelet counts of 30-20,000/μl and spontaneous hemorrhage at levels below 10,000/μl.
