Thrombocytosis is an increase in the number of platelets in your blood. This is a condition that can be life-threatening as it can lead to thromboembolic complications such as heart attack and stroke. What are the causes and symptoms of thrombocythemia? How is this condition treated?

Thrombocytosismeansan increase in the number of plateletsover 600,000 / µl (600 G / L), which is due to excessive producing tiles rather than extending their survival time. Depending on the causes, there are primary, secondary and pseudo thrombocythemia.

Platelets (thrombocytes, PLT) are responsible for the proper clotting of blood. If a blood vessel is damaged, the thrombocytes attach to each other and to the edges of the damaged vessel, thereby inhibiting blood flow. If their amount is increased, blood clotting does not take place properly, which increases the risk of blood clots and bleeding.

Thrombocytosis - Causes

Primary causes of thrombocythemia ( excessive platelet countis the result of an autonomic proliferative process):

Essential thrombocythemia occurs most often in the fifth and sixth decade of life, slightly more often in women than in men

  • essential thrombocythemia(ET,essential thrombocythemia ), which belongs to myeloproliferative neoplasms
  • other myeloproliferative syndromes such as polycythemia vera, marrow fibrosis, chronic myeloid leukemia, chronic myelomonocytic leukemia)
  • familial thrombocythemia (mutations of the TPO gene

Secondary thrombocythemia is a symptom of a disease or the result of certain factors

  • inflammation (e.g. in tuberculosis, sarcoidosis, rheumatoid arthritis, ulcerative colitis)
  • cancer
  • effect of splenectomy (removal of the spleen) and other surgical procedures
  • iron deficiency
  • alcoholism
  • medications (e.g. vincristine, tretinoin, oral contraceptives)
  • effort (exertional thrombocytopenia, lasting 15-30 minutes)
  • frequent blood donation (in blood donors)

Causes of pseudo-thrombocythemia

  • microspherocytosis
  • cryoglobulinemia
  • schistiocytosis

Thrombocytosis - symptoms

Essential thrombocythemia manifests as recurrent bleeding or thrombotic changes. The site of bleeding is the gastrointestinal tract, urinary tract and nasal mucosa. Blood clots are less frequent than bleeding and affect the splenic, mesenteric or cerebral vessels. Then, paresthesia, hemiplegia, epileptic seizures and even visual disturbances may occur. A stroke can occur if a blood clot occurs in the brain. In addition, half of the patients have enlarged spleen.

Secondary thrombocythemia is usually asymptomatic, although only the bleeding time may be prolonged.

Thrombocytosis - diagnosis

If thrombocythemia is suspected, blood and bone marrow tests are performed. If the results of these tests are questionable and do not give a clear answer to the question of what is the cause of the high platelet count, your doctor may also order cytogenetics and molecular tests.

In addition, the doctor should check whether the disease is caused by polycythemia vera, primary myelofibrosis, chronic myeloid leukemia or myelodysplastic syndrome.

Thrombocytosis - treatment

Patients are given aspirin in a dose of 75-100 mg / day, unless there are contraindications, which is to prevent blood clots. Moreover, depending on the presence of risk factors, the doctor uses cytoreductive treatment. It should be used in people over 60 years of age with a platelet count greater than 1500x109 / l, with a history of thrombotic episodes or spontaneous bleeding. This group also includes patients with cardiovascular risk factors.

Source:

Bibliography: Mariańska B., Fabijańska-Mitek J., Windyga J., Laboratory tests in hematology, PZWL Medical Publishing, Warsaw 2003

Institute of Hematology and Transuziology, www.ihit.waw.pl

Category:

Cardiology