Occurence, etiology, and clinical significance of extreme thrombocytosis: A study of 280 cases

Buss, David H.; Cashell, Alan W.; O'Connor, M. L.; Richards, Frederick; Case, L. Douglas

doi:10.1016/0002-9343(94)90150-3

Cited by 195 publications

(139 citation statements)

References 12 publications

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“…138 Other conditions commonly associated with reactive thrombocytosis include infection, postsplenectomy state, acute blood loss, and iron deficiency. 165,166 Paraneoplastic thrombocytosis is thought to occur from tumor production of cytokines such as IL-6. 140,155 Serum IL-6 levels have been used to distinguish paraneoplastic and other reactive thrombocytosis processes from clonal etiologies such as essential thrombocythemia, polycythemia vera, myelodysplasia, and acute and chronic leukemia.…”

Section: Paraneoplastic Hematologic Syndromesmentioning

confidence: 99%

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Pelosof

Gerber

2010

Mayo Clinic Proceedings

582

514

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Section: Paraneoplastic Hematologic Syndromesmentioning

confidence: 99%

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Pelosof

Gerber

2010

Mayo Clinic Proceedings

582

514

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“…In our case the differential diagnosis of a megakaryoblastic crisis of CML with a \de novo" acute megakaryocytic leukemia is based on the presence of a transcription BCR/ABL with a protein of 210 kDa together with the expression of platelet-specific antigens CD41, CD61 on blast surface, the slight basophilia and left-shifted leukocytes. In asymptomatic CML marked thrombocytosis is seen in 41% of cases with only 0.9% experiencing evidence of thrombosis [4]. A literature search reveals that there is only one case report with digital cyanosis, headache, vertigo, and malaise due to extreme thrombocytosis during CML [5].…”

Section: Discussionmentioning

confidence: 99%

Megakaryocytic blast crisis as first presentation of chronic myeloid leukemia

Campiotti

Grandi

Biotti³

et al. 2006

American J Hematol

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We describe an extremely rare case of megakaryocytic blast crisis as first presentation of chronic myeloid leukemia. The patient had a very high platelet count and developed an ischemic stroke with seizures. She was treated with hydroxyurea, platelet apheresis, ARA-C, and idarubicin in order to obtain a prompt reduction of thrombocytosis and then with imatinib 600 mg/die PO. The therapy induced a complete hematological remission with a resolution of neurological signs within 4 weeks. Am. J. Hematol. 82:231-233, 2007.

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“…17 The term 'reactive' is used to imply that platelet production has increased as a reaction to an underlying condition, generally an infectious or inflammatory disorder. [2][3][4][5][6][7]9,20 Thromboembolic and hemorrhagic complications are rare in patients with reactive thrombocytosis and anti-platelet or cytoreductive treatments are not usually needed, unless other risks are identified. 20,21 Thrombocytosis can also be classified according to severity, as judged by the peak platelet count.…”

Section: Extreme Thrombocytosis Se Wiedmeier Et Almentioning

confidence: 99%

“…[2][3][4][5][6][7] We recently reported platelet counts of over 47 000 of the subjects obtained during the first 90 days after birth, and observed that the 95th percentile upper reference range can be as high as 750 000 ml À1 . 8 Adult patients with very high platelet counts can be at risk for significant thromboembolic and/or hemorrhagic complications, [9][10][11][12][13][14][15][16][17][18][19][20] but it is unclear whether similar risks exist for young infants. Moreover, neither the prevalence and causes of thrombocytosis nor the associated conditions or outcomes in infants are well known.…”

Section: Introductionmentioning

confidence: 99%

Thrombocytosis in neonates and young infants: a report of 25 patients with platelet counts of ⩾1 000 000 μl−1

et al. 2009

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Objective: Thrombocytosis has been reported in neonates and young infants, but little is known of its prevalence, timing of onset, associated conditions, sequelae and outcomes. To better understand this condition, we used the data repositories of a multi-hospital health-care system to identify all individuals p140 days old (20 weeks) who, during the past 6 years, had a platelet count of X1 000 000 ml À1 . Study Design:We identified all infants with extreme thrombocytosis (using the Sutor definition of a platelet count of X1 000 000 ml À1 ) during the period of January 2003 through December 2008 in any Intermountain Healthcare facility. We obtained the information provided in this report from electronic and paper records.Result: Among 40 471 infants who had one or more platelet counts performed in this period, 25 had extreme thrombocytosis. No cases were identified in the first week after birth, 40% were recognized between the second and fourth weeks and 40% between the fifth and eighth week. The prevalence of thrombocytosis had no relationship with birth weight or gestational age but a slight predominance of female patients (15/25) was noted. In all, 26 episodes were found among the 25 infants: 12 episodes involved an antecedent infectious disease, 8 had an antecedent surgical procedure, 4 had the anemia of prematurity and 1 each had congenital adrenal hyperplasia and opiate withdrawal syndrome. No pathological thromboses or hemorrhages or other sequelae were detected and all episodes resolved with no deaths. Conclusion:The thrombocytosis cases that we report were all consistent with reactive thrombocytosis (also known as secondary thrombocytosis); none seemed to be essential (primary) thrombocytosis. We speculate that the pathogenesis involves increased platelet production due to megakaryopoietic stimulators induced by an infectious or inflammatory condition. From this series and previous reports, young infants with platelet counts up to 1 300 000 ml À1 do not seem to have a significant risk of thrombotic or hemorrhagic problems, and do not generally require anti-platelet or cytoreductive treatment.

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Occurence, etiology, and clinical significance of extreme thrombocytosis: A study of 280 cases

Cited by 195 publications

References 12 publications

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Megakaryocytic blast crisis as first presentation of chronic myeloid leukemia

Thrombocytosis in neonates and young infants: a report of 25 patients with platelet counts of ⩾1 000 000 μl−1

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