Thrombocytosis is a condition, characterized by excess production of thrombocytes. Such a type of disorder can cause development of thrombosis in affected individuals.
Reactive thrombocytosis seldom produces any symptoms. In cases, when individuals suffering from the condition present with symptoms, they primarily occur due to the underlying disease. Individuals with reactive thrombocytosis, experience chest pain, undue fatigue, weakness, dizziness accompanied by fainting. In addition, they can also experience changes in vision and development of numbness in hands and feet .
A preliminary physical examination to study the signs and symptoms of the disease followed by blood tests to check for levels of platelets forms the basis of treatment regime. Physical examination would reveal splenomegaly, or may show signs of infection.
These tests are done along with blood smear test, which is required to study the condition of platelets. A platelet count beyond 500,000 microliter of blood suggests that there is an underlying disease condition that is causing thrombocytosis. In many cases, repeat blood tests would be ordered after specific period of time to check whether the platelets levels are constantly high .
In addition to the above mentioned tests, the following would also be required to diagnose thrombocytosis:
Treating underlying condition can help resolve thrombocytosis. If infections are the cause, then platelet counts tend to remain high until the underlying cause is corrected. However, in cases, when the spleen has been removed, then individuals have to live with the condition of thrombocytosis for the rest of their life. In such situations, the affected individuals are given low dose aspirin in order to prevent blood clots .
With successful treatment of underlying condition, secondary thrombocytosis can be well managed, as the disorder does not cause blood clotting. The platelet counts return to normal after the infections have been treated or the disease condition properly addressed to. However, in individuals with primary thrombocytosis, there are higher chances of blood clotting and therefore individuals are given medications to keep the levels of platelet normal. After many years, such individuals can develop bone marrow fibrosis, which can eventually lead to onset of leukemia .
Several factors cause increase in the number of platelets in the blood. One of the major cause being bone marrow diseases, which cause the bone marrow to produce more megakaryocytes, triggering overproduction of platelets in blood. Other factors which also cause thrombocystosis include blood loss due to severe bleeding, myocardial infarction, infections, cancer, allergic reactions, kidney disorders, trauma, surgical procedures and conditions of pancreatitis. In addition to these factors, certain medications such as epinephrine, vincristine and tretinoin can also cause development of reactive thrombocytosis .
Reactive thrombocytosis is a common phenomenon unlike the primary type, with a postsplenectomy incidence rate of about 75 to 82% . Statistics have also revealed that, secondary or the reactive form of thrombocytosis occurs in about 3 to 13% of children who are hospitalized.
About 6000 cases of primary thrombocytosis occur in the US every year. If young adults are considered to be affected by the condition, then more women are known to be affected than men. Such a type of disease condition rarely strikes the children population .
In the essential thrombocytosis, there is increased platelet count due to an underlying bone marrow disease. Bone marrow is a spongy material present within the bones, which contain stem cells that become white blood cells, platelets or red blood cells. Conditions that interfere with this mechanism causing excessive production of one of the blood components gives rise to the phenomenon of thrombocytosis. In bone marrow diseases, there is increased production of cells known as megakaryocytes, which in turn releases excessive amounts of platelets in the circulation .
On the other hand, the reactive or secondary form of thrombocytosis occurs due to increased production of proinflammatory cytokines, like interleukin 1, 6 and 11. Such a type of event primarily occurs in conditions of infections, chronic inflammation or malignancy .
So far no strategies have been designed to prevent thrombocytosis. However, steps can be taken to prevent the onset of complications. Adhering to a healthy lifestyle that includes quitting smoking, decreasing alcohol consumption and effective management of high blood pressure and diabetes can help prevent complications from occurring. Affected individuals are also advised against taking over the counter pain medications. It has also been advised that, individuals who are on blood thinning medications should tell the same to their doctor before undergoing any surgical procedures.
Thrombocytosis can be either primary or secondary in nature, depending on the causative factor. Excess production of platelets can call for onset of several conditions such as stroke, development of clot in blood vessels or myocardial infarction. When thrombocytosis is caused by an underlying disease condition, then it is termed as reactive or secondary thrombocytosis. In instances, when bone marrow diseases are the cause, then the condition is known as essential or primary thrombocytosis. Of the two forms, the latter one is more prone to favor the development of blood clots in affected individuals .