Laboratory Investigations
– Complete blood count (CBC) with platelet count (thrombocytopenia or anemia)
– Peripheral blood smear (platelet morphology, blasts, schistocytes)
– Coagulation panel: prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR)
– Liver function tests and kidney function tests
– Vitamin levels (vitamin C, K, B12, folate)
– Specific tests: von Willebrand factor antigen/activity, factor VIII/IX assays, platelet function tests
– Additional tests as indicated: autoimmune markers (ANA, anti‑dsDNA), viral hepatitis panels, HIV test, D‑dimer, fibrinogen.
Imaging and Further Diagnostics
In more complex cases, imaging may help: ultrasound of the abdomen for organomegaly, CT or MRI to locate internal bleeding, bone marrow biopsy for suspected leukemia, and skin biopsy if vasculitis is suspected.
Treatment and Management