Thrombocytosis in the NICU

Abstract

An elevated platelet count may occur during care of neurology/neurosurgical patients and is usually due to reactive or secondary thrombocytosis (ST) caused by inflammation or infection. Primary (clonal) thrombocythemia or essential thrombocythemia associated with myeloproliferative disorders is usually known before or during early patient assessment. Rarely, paraneoplastic causes of thrombocytosis may be discovered. Although no single test differentiates primary from secondary etiologies, laboratory tests that show increased acute phase responses, such as C-reactive protein, fibrinogen, erythrocyte sedimentation rate, and interleukin-6, may be useful in diagnosing ST. Thrombosis due to ST is rare in any platelet count. ST, however, should be considered within the overall risk assessment for thromboembolism in any patient. If treatment is initiated, low-dose aspirin is sufficient.

Persistent Thrombocytosis in a Case of Pseudomyxoma Peritonea Post CRS and HIPEC -A Case Report

“…The reactive thrombocytosis found in patients with systemic inflammatory diseases is not the product of the isolated action of thrombopoietin, but its interaction with other plasma cytokines such as interleukin-6 [3]. Although the diagnostic tests to differentiate essential and reactive thrombocytosis are not easy to perform, laboratory tests that show increased acute phase reactants such as C-reactive protein, fibrinogen, erythrocyte sedimentation rate and interleukin-6 may be useful in the diagnosis of reactive thrombocytosis [4]. It is accepted that lower levels of platelets 1.000.000. μL-1 are a benign condition, although it remains unclear if these findings are associated with an increased post-operative thromboembolic or hemorrhagic risk.…”

Postoperative thrombocytosis: An unusual case report

“…Although the diagnostic tests to differentiate essential and reactive thrombocytosis are not easy to perform, laboratory tests that show increased acute phase reactants such as C-reactive protein, fibrinogen, erythrocyte sedimentation rate and interleukin-6 may be useful in the diagnosis of reactive thrombocytosis. [ 7 ] It is accepted that upto 1,000,000 μL −1 platelets level are a benign condition, although it remains unclear if these findings are associated with an increased postoperative thromboembolic or haemorrhagic risk. Prophylactic treatment with platelet inhibitors in these situations is controversial, although some authors do consider management of low-dose acetylsalicylic acid appropriate.…”

Advanced Assessment of Platelet Function during Adult Donor Care

“…4,6 Other proteins, including interleukin 6 (common among donors), may also stimulate platelet formation and cause abnormally high platelet concentrations (thrombocytosis). 8 The incidence of thrombocytosis among donors has not been reported, but its occurrence in critically ill patients does not produce abnormal clotting. 8 Two primitive cell types are present within bone marrow.…”

“…8 The incidence of thrombocytosis among donors has not been reported, but its occurrence in critically ill patients does not produce abnormal clotting. 8 Two primitive cell types are present within bone marrow. One forms precursors for lymphocytes, leukocytes, and monocytes whereas the other forms red blood cells and megakaryocytes.…”