In this episode of The Good GP, host Dr Tim Koh welcomes distinguished guest Professor Chan Cheah, a clinical and laboratory-based haematologist with a special interest in lymphoma. Professor Cheah, who practises at Sir Charles Gairdner Hospital and works with Western Diagnostic Pathology, explores the challenges and considerations of managing thrombocytopenia in general practice.

Professor Cheah begins by explaining what thrombocytopenia is and discusses its prevalence. He addresses common causes and sheds light on the pitfalls like pseudothrombocytopenia—where an artificial drop in platelet counts occurs due to platelet clumping in EDTA-treated tubes. Important advice is shared on how a different anticoagulant, such as citrate, can be used to overcome this issue.

He also explains the various age-related factors that should guide a GP's differential diagnosis process and details how different conditions might mimic or contribute to thrombocytopenia. He discusses important associated conditions such as Immune Thrombocytopenic Purpura (ITP), medication-induced reductions, and other infections that can manipulate platelet counts.

They then pivot to the necessary diagnostic steps and laboratory investigations that are vital in assessing a patient with low platelets. Professor Cheah rounds off the discussion by covering urgent conditions like thrombotic microangiopathies and other haematological abnormalities, stressing the importance of urgent and precise diagnosis in severe scenarios.

Join Professor Chan Cheah in uncovering the critical aspects of diagnosing and managing low platelet counts, a commonly encountered yet complex issue in general practice.

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