Clinical Presentation and Etiology of Thrombocytopenia Among Patients at a Tertiary Care Hospital in the Kingdom of Saudi Arabia

Background Thrombocytopenia is a common hematological disorder encountered in clinical practice. To improve diagnostic efficiency and patient outcomes, it is important to understand its frequent clinical manifestations and predominant etiologies in different healthcare settings. This study aimed to describe the typical clinical presentations and underlying causes of thrombocytopenia among patients at a tertiary care hospital in the Kingdom of Saudi Arabia. Study design A single-center, retrospective cross-sectional study. Materials and methods Patients with thrombocytopenia (platelet count < 150,000/microL) admitted between January and December 2022 were included. Patients with pseudothrombocytopenia were excluded. Demographic, clinical, and laboratory data were collected through manual review of electronic medical records. Etiologies were recorded, and statistical analysis was performed using Stata software. Here and throughout, n denotes the number of patients contributing data to a given comparison, and N denotes the total cohort (N = 114). Where applicable, denominators were adjusted for missing data. Results Of 114 patients, 73 (64.04%) were male. The mean age was 40.80 ± 15.93 years, and the mean length of hospital stay was 11.83 ± 15.73 days. The mean platelet count was 51,480 ± 39,690/microL. Mild thrombocytopenia was observed in 19 (16.67%) patients, moderate in 31 (27.19%), and severe in 64 (54.14%). Infection was the most common etiology (n = 48, 42.11%), with Plasmodium species accounting for the largest number of cases (n = 25). Bleeding manifestations were observed in 72 (63.07%) patients, most commonly epistaxis (n = 16, 14.04%), ecchymosis (n = 13, 11.4%), and petechiae (n = 9, 7.89%). Patients with bleeding, particularly petechiae, ecchymosis, epistaxis, and gum bleeding, had significantly lower platelet counts than those without bleeding symptoms. Conclusion Infections were the predominant cause of thrombocytopenia in this cohort. Lower platelet counts were significantly associated with bleeding manifestations, particularly epistaxis, emphasizing the need for early recognition and appropriate clinical management.