From Diagnosis to Treatment: Navigating the Clinical Challenges of Dialyzer-Associated Thrombocytopenia

Thrombocytopenia is a common lab finding. The two fundamental groups are lack of production versus overconsumption of platelets. When common causes of thrombocytopenia have been ruled out and less common causes, such as thrombotic microangiopathic conditions, have been considered, it is important to keep in mind that patients undergoing dialysis may develop thrombocytopenia from the dialyzer itself. This case is of a 51-year-old male who presented originally with celiac artery dissection and acute kidney injury requiring emergent dialysis. He ultimately developed thrombocytopenia during his hospitalization. It was initially presumed to be from thrombocytopenic purpura without improvement after plasmapheresis. No clear etiology was identified until it was suspected that the dialyzer was the source of thrombocytopenia. After changing the dialyzer type, the patient's thrombocytopenia resolved. Dialyzer-associated thrombocytopenia is a rare but reversible complication of hemodialysis. It is important to keep this differential in mind for patients undergoing hemodialysis.