The likely diagnosis is grey platelet syndrome complicated by myelofibrosis.
Further investigations would include: - Repeat review of blood film for large agranular platelets
- Electron microscopy (to demonstrate absent alpha granules)
- Assessment of platelet alpha granule consituents (e.g. PF4 assay)
- Bone marrow aspirate and trephine to delineate degree of fibrosis
| 