Severe thrombocytopenia (i.e., a platelet count < 10,000/micro-liter of peripheral blood) is a medical emergency, as it frequently leads to spontaneous hemorrhage. It is attributed to multiple causes. Though platelet transfusion is an urgent need in most of the patients with severe thrombocytopenia, there are conditions like thrombotic thrombocytopenic purpura (TTP) which is rather a contra-indication for platelet transfusion in spite of having severe thrombocytopenia. 
Platelet transfusion in a patient with TTP may aggravate thrombus formation in the micro-vasculatures leading to further complications. A simple, timely screening of a peripheral blood film can exclude the possibility of TTP. A thorough screening of a peripheral blood film is, thus, a crucial step before giving a platelet transfusion. A plasma exchange with fresh frozen plasma (FFP) or cryoprecipitant, and anti-CD20 (Rituximab) with low dose corticosteroids comprise the first line of treatment protocol for TTP. The current mortality rate of untreated TTP is more than 90%. In conclusion, a simple screening of a peripheral blood film is of utmost importance even in the era of highly sophisticated automation and ancillary investigations.
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Other recent articles of Dr Biswadip Hazarika published in Jan / February, 2012.
International Journal of Laboratory Hematology, Official journal of International Society of Laboratory Hematology
Aricle: Myeloperoxidase staining with diluted Giemsa with phosphate buffer of pH6.8 as a counterstain. (Authors: Biswadip Hazarika, Dep’t of Pathology, Gulf Medical University, Ajman, UAE and Jyotibon Dutta of Dep’t of Biotechnology, IIT, Guwahati, India)
BLOOD, Official journal of American Society of Hematology (ASH)
BloodMed, a joint venture of British Society for Haematology (BSH) and Wiley-Blackwell
BloodMed, a joint venture of British Society for Haematology (BSH) and Wiley-Blackwell
Dr. Biswadip Hazarika
MD, Hematopathologist
Gulf Medical University, Ajman, UAE
