Jebmh.com Original Research Article J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 5/Issue 12/March 19, 2018 Page 1100 A STUDY TO EVALUATE THROMBOCYTOPENIA IN A TERTIARY CARE HOSPITAL Rajib Paul 1 , Sumayya Mushtaq 2 , Aparna Yerramilli 3 , Sri Lakshmi 4 , Rithvik Ryaka 5 , Pradeep Kumar 6 , Swetha Priya 7 1 Consultant Physician and Intensivist, Apollo Hospital, Jubilee Hills, Hyderabad. 2 Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, Hyderabad, India. 3 Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, Hyderabad, India. 4 Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, Hyderabad, India. 5 Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, Hyderabad, India. 6 Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, Hyderabad, India. 7 Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, Hyderabad, India. ABSTRACT BACKGROUND Thrombocytopenia is defined as platelet value less than 150 × 10 3 per μL or 50% decrease from the baseline. It can be idiopathic, immune mediated and drug induced, or disease induced. The aim and objective of the present study was undertaken to evaluate the incidence and causes of thrombocytopenia, severity based on disease specific conditions and to study the management of thrombocytopenia in adult patients. MATERIALS AND METHODS It was a prospective observational study undertaken at a tertiary care hospital. A structured pro forma was prepared and data was collected from patients of either gender ≥18 years with platelet count less than 150 × 10 3 per μL during their hospital stay. Details regarding platelet levels, demographics, and laboratory parameters, prescribed and discharged medications were collected. Aetiology was categorised as either drug induced, disease induced or immune mediated. RESULTS Data from 200 inpatients with thrombocytopenia was collected during the study period among which 66 % were males. Mild thrombocytopenia was found in 40.5% cases followed by moderate 26% and severe 33.5%. Out of the established cases, co- morbidities like cancer, dengue, malaria and few undetermined co-morbidities were seen in 28%, 6%, 5% and 5.5% patients respectively. Patients were treated with either a steroid or a platelet transfusion or with combination of drugs and platelet transfusion. CONCLUSION In the present study, mild thrombocytopenia was most prevalent followed by severe and moderate. Cancer was a major co- morbid condition. Steroids were the first line treatment followed by platelet transfusions. KEYWORDS Cancer, Dengue, Malaria, Platelets, Thrombocytopenia. HOW TO CITE THIS ARTICLE: Paul R, Mushtaq S, Yerramilli A, et al. A study to evaluate thrombocytopenia in a tertiary care hospital. J. Evid. Based Med. Healthc. 2018; 5(12), 1100-1102. DOI: 10.18410/jebmh/2018/227 BACKGROUND Thrombocytopenia is defined as a platelet count of less than 150 × 10 3 per μL or less than 50% of the baseline count. Thrombocytopenia results from decreased bone marrow production, increased breakdown of platelets in the bloodstream or splenic sequestration. 1 Platelets are released from the megakaryocyte, under the influence of flow in the capillary sinuses. The normal blood platelet count is 1,50,000 - 4,50,000/µL. The major regulator of platelet production is the hormone thrombopoietin (TPO), which is synthesized in the liver. Synthesis is increased with inflammation specifically by interleukin 6. TPO binds to its receptor on platelets and megakaryocytes, by which it is removed from the circulation. Thus, a reduction in platelet and megakaryocyte mass increases the level of TPO, which then stimulates platelet production. Platelets circulate with an average life span of 7–10 days. Approximately one-third of the platelets reside in the spleen, and this number increases in proportion to splenic size, although the platelet count rarely decreases to < 40,000/L as the spleen enlarges. 1 Objectives of our study included study of incidence and causes of thrombocytopenia in adult inpatients, observation and reporting of the severity of thrombocytopenia based on disease specific conditions, study of the management of thrombocytopenia and finally to study the therapeutic outcomes in patients diagnosed with thrombocytopenia. Financial or Other, Competing Interest: None. Submission 16-02-2018, Peer Review 21-02-2018, Acceptance 28-02-2018, Published 19-03-2018. Corresponding Author: Dr. Rajib Paul, Consultant Physician and Intensivist, Apollo Hospital, Jubilee Hills, Hyderabad. E-mail: drrajibpaul@gmail.com, drrajibpaul.apollo@gmail.com DOI: 10.18410/jebmh/2018/227