Thrombocytosis

Excessive platelet production by the body is termed as thrombocytopenia.

Platelets are the cells of blood which help to coagulate the blood during bleeding.

There are two types of thrombocytopenia according to the origin of the disease:

Primary or autonomous thrombocytopenia where it is caused by blood or bone marrow disease and secondary or reactive thrombocytopenia in which it is caused due to some underlying disease.

The complications of primary, also known as essential thrombocytopenia can be dangerous or in some cases, life-threatening.

Therefore, proper diagnosis and treatment is essential.   

Thrombocytopenia is usually associated with an underlying disease, therefore signs and symptoms relate to that disease.

But some symptoms of thrombocytopenia are:

• headache,
• lightheaded,
• chest pain,
• weakness,
• fainting,
• vision changes
• numbness or tingling sensation in hand.    

The causes of thrombocytosis vary depending on its type.

Thrombocytes are produced in the bone marrow (the spongy tissue inside the bone).

Essential thrombocytosis results as a result of excessive production of megakaryocytes (precursor of thrombocytes).

The causes of reactive thrombocytosis are as follows:

• Acute bleeding,
• allergic reactions,
• cancer,
• chronic kidney failure,
• exercise,
• heart attack,
• coronary artery bypass,
• infections,
• vitamin deficiency,
• removal of spleen,
• hemolytic anemia (decrease in the number of red blood cells due to their excessive destruction),
• inflammation,
• autoimmune disorders,
• major surgery,
• pancreatitis,
• trauma,
• burns,
• exercise,
• some medications like
  • Epinephrine,
  • Tretinoin,
  • Heparin sodium.         

Thrombocytosis is difficult to diagnose with physical check-up only.

During physical examination enlarged spleen can be detected along with other signs. Those signs may be similar with other blood diseases.

Therefore, some additional tests will be really important in confirming diagnosis like the following:

A routine blood test which will determine count of all blood cells and pathological cells and inclusions. A blood smear to see the characteristics of platelets like the size and activity. The doctor would to repeat the test because many other conditions may temporarily increase the amount of platelets.

If the blood count shows the number of thrombocytes more than 450,000 (normal range is 150,000-450,000), then the doctor is likely to look for an underlying cause.

So, some more tests would be performed:

• level of iron in blood is checked,
• testing markers of inflammation,
• genetic testing for bone marrow disorders
• bone marrow aspiration for further laboratory testing.    

Since thrombocytosis is mostly associated to an underlying disease, therefore treating that disorder would be the priority.

In the case of reactive thrombocytosis, it is highly unlikely, that any kind of medications are needed to lower the platelet count.

Treating the main disease that led to thrombocytosis would lower the platelet count and prevent any complications.

But in the case of primary thrombocytosis which can lead to life-threatening condition, it should be treated by special methods namely, bone marrow transplantation or giving medications like fibrinolytics chronically according to schedule.

The following may help to prevent the development of thrombocytopenia and its complications:

• avoid infections by following proper hygienic methods,
• doing proper exercise and not exceeding required limits,
• proper nutrition,
• avoid traumas.  

A family history of thrombocytosis or other blood conditions causing thrombocytosis can be a major risk factor.

Some additional risk factors include:

• having kidney diseases,
• splenectomy (removal of spleen),
• vitamin deficiency,
• having autoimmune disorders.

The major complication of increased amount of thrombocytes is thrombosis (clot formation) which may narrow or completely obliterate the lumen of the blood vessels leading to decreased or absence of blood flow to the organ associated to blood vessel which in turn results in organ failure.

This thrombus (clot) breaks out from the original place and lodging into a different place forming a clot into small vessels or capillaries, this is known as embolism.

This embolus (newly formed clot) may completely block the vessel resulting in organ failure.