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The diagnosis of immune thrombocytopenic purpura is established only by ruling out other causes of thrombocytopenia. The patient's history, the findings on physical examination, the blood counts, and the findings on examination of the blood smear are usually sufficient.1,2 Examination of the blood smear is essential to rule out in vitro platelet clumping that can cause
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From the Departments of Medicine and Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City.
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