Clinical PictureAlthough thrombocytopenia may be associated with easy bruising and bleeding gums, patients may complain min-imally about these. Patients without signs or symptoms of bleeding are considered to have asymptomatic throm-bocytopenia. Major bleeding episodes tend to occur when the platelet count is <30,000/mm3. Minor bleeding episodes occurred in 16 of 68 patients (24%) in 1 large study and included epistaxis, gum bleeding, petechia, and bruis-ing.52 Among a series of 15 patients with platelet counts of <50,000/mm3, 40% complained of epistaxis, rectal bleeding, or easy bruising; 1 patient died of intracranial hemorrhage.53 The risk of intracranial hemorrhage is greatest during the first 1 or 2 weeks of symptoms. Such bleeding usually occurs within a few days of the onset of symptoms.54
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