Serial serum thrombopoietin levels in a pregnant woman with essential thrombocythaemia

Abstract

Thrombopoietin (TPO) is a ligand for c-mpl, which regulates the differentiation and maturation of megakaryocytes. Essential thrombocythaemia (ET) is a clonal myeloproliferative disorder. It has been reported that the platelet count declines during pregnancy in ET patients. We examined serial changes in the serum TPO level during the course of pregnancy in a patient with ET. The serum TPO level showed significant negative correlation with the platelet count. Although it mimicked the normal feed back system, the TPO levels were consistently higher than the normal upper limit. Accumulation of these data will be helpful in revealing the pathogenesis of ET and the decline in the platelet count during pregnancy.

A single institutional experience with 43 pregnancies in essential thrombocythemia

“…The cause of this phenomenon is unclear but may be similar to that in normal pregnancy, in which platelet counts typically decrease by 10±15% of the pre-pregnancy level from 11 to 15 wk of gestation to 36±40 wk (57,58). Other possible mechanisms include an increase in platelet consumption (17), a hormonal response (45), placental or fetal production of a factor that reduces platelet production (54), and a cytokine-mediated decrease in megakaryocyte number (56).…”

Marked Rebound of Platelet Count in the Early Postpartum Period in a Patient with Essential Thrombocythemia

“…It remains unknown whether the platelet count will decrease after some time without Case Reports in Hematology treatment if it rebounds. According to our searches in the English literature, some reports indicate that no particular cytoreductive therapy was required after delivery, whereas other reports describe cases in which patients were treated for a rebound of platelet count [14][15][16][17][18]. Sakai et al reported a case in which the platelet count increased to ≥1000 × 10 9 /L within 3 months after delivery and another case in which the platelet count increased to ≥800 × 10 9 /L within 2 months after delivery.…”