Reactive thrombocytosis

Platelet counts of >450 x 109/L occur as a reactive phenomenon and may be seen in:

• Following surgery, especially splenectomy.

• Malignancy e.g. underlying carcinoma.

• Chronic inflammatory states e.g. collagen disorders.

• Blood loss and iron deficiency.

• Rebound in response to haematinics and/or chemotherapy.

• Any severely ill patient on ITU.

Raised platelet count in clonal haematological disorders occurs in CML, 254 ET, PV, IMF and also in MDS (esp. 5q- syndrome).

In reactive thrombocytosis platelets are usually <1000 x 109/L but levels of 1500 x 109/L may occur. Platelet morphology usually normal but differentiation from ET relies on full clinical evaluation. No specific treatment is required for reactive thrombocytosis. Short term anticoagulant or antiplatelet therapy is advised for marked thrombocytosis in the immediate post-splenectomy period.

0 0

Post a comment