Why thromboembolism occurs in some patients with thrombocytopenia and treatment strategies

Thromb Res. 2020 Dec:196:500-509. doi: 10.1016/j.thromres.2020.10.005. Epub 2020 Oct 8.

Abstract

Platelets play such an important role in the process of thrombosis that patients with thrombocytopenia generally have an increased risk of bleeding. However, abnormal thrombotic events can sometimes occur in patients with thrombocytopenia, which is unusual and inexplicable. The treatments for thrombocytopenia and thromboembolism are usually contradictory. This review introduces the mechanisms of thromboembolism in patients with different types of thrombocytopenia and outlines treatment recommendations for the prevention and treatment of thrombosis. According to the cause of thrombocytopenia, this article addresses four etiologies, including inherited thrombocytopenia (Myh9-related disease, ANKRD26-associated thrombocytopenia, Glanzmann thrombasthenia, Bernard-Soulier syndrome), thrombotic microangiopathy (thrombotic thrombocytopenic purpura, atypical hemolytic uremic syndrome, hemolytic uremic syndrome, Hemolysis Elevated Liver enzymes and Low Platelets syndrome, disseminated intravascular coagulation), autoimmune-related thrombocytopenia (immune thrombocytopenic purpura, antiphospholipid syndrome, systemic lupus erythematosus), and acquired thrombocytopenia (Infection-induced thrombocytopenia and drug-induced thrombocytopenia, heparin-induced thrombocytopenia). We hope to provide more evidence for clinical applications and future research.

Keywords: Mechanism; Platelet; Thrombocytopenia; Thrombosis; Treatment.

Publication types

  • Review

MeSH terms

  • Disseminated Intravascular Coagulation*
  • Humans
  • Purpura, Thrombocytopenic, Idiopathic*
  • Purpura, Thrombotic Thrombocytopenic*
  • Thromboembolism* / complications
  • Thrombotic Microangiopathies*