Diagnosis of
immune thrombocytopenia (
ITP) is based on clinical suspicion and normal peripheral smear except for
thrombocytopenia. Bone marrow examination is carried out to rule out
leukemia,
myelodysplastic syndrome or
aplastic anemia. However, in most cases, clinical diagnosis is not altered after the bone marrow reports. Hence, this present study was carried out to evaluate the justification for bone marrow examination in the setting of isolated
thrombocytopenia. All patients presenting to the hematology OPD with isolated
thrombocytopenia and suspected diagnosis of
ITP, between October 2011 and April 2013, were included in the study. Data was collected from bone marrow reports and outpatient records. A total of 353 cases were found. 319 cases had features of typical
ITP and the rest had some form of organomegaly and/or
lymphadenopathy. Bone marrow examination in all cases revealed normal hematopoietic elements and prominence of megakaryocytes including juvenile forms with no novel diagnosis in any patient. Routine use of bone marrow examination in the diagnostic workup of isolated
thrombocytopenia is not required in our center even if
steroids are planned as a first line
therapy. However, a detailed history, thorough examination with complete hemogram and peripheral smear examination are essential.