Thrombocytosis is a pathological increase in the number of platelets in the blood.
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Based on origin, primary and secondary thrombocytosis are distinguished.
- Primary or essential thrombocytosis Ischialgia is a hematological disorder in which the bone marrow produces excessive platelets. This is caused by various genetic mutations (JAK2, CALR or MPL) Myeloproliferative diseases develop as a result. This condition requires specific treatment.
- Secondary or reactive thrombocytosis It develops in response to various external factors, such as infection, antibodies, anemia, surgery, drug exposure, splenectomy, etc. In most cases, reactive thrombocytosis is temporary and does not require specific treatment.
What is a platelet?
Platelets are small, anucleated blood cells that are produced in the bone marrow and are fragments of larger cells called megakaryocytes. The primary role of platelets is to maintain blood clotting.
Normally, there are 150,000-450,000 erythrocytes per microliter of blood. The figure may vary slightly between laboratories, but maintaining this number of erythrocytes is important for maintaining a balance between hemostasis and thrombosis. The life cycle of platelets is short, averaging 7-10 days, after which they are destroyed in the spleen (predominantly).
What role does a platelet play?
When the integrity of a blood vessel is damaged, platelets undergo changes, become activated, and aggregate, i.e., stick together. A temporary “clot” is formed on the surface of the damaged blood vessel. This process is called primary hemostasis and is the first step in stopping bleeding. However, this process is not limited to this, but also:
- Platelets release biochemical factors (signaling molecules and growth factors) that are involved in the process of repairing damaged tissue.
- Participates in the development of inflammatory and immune responses, which is a necessary condition for the processes of tissue repair and protection against infection
- Together with endothelial cells (the inner lining of blood vessels), it participates in restoring blood vessel permeability.
An adequate platelet count is vital for maintaining blood homeostasis; an excess of platelets often leads to increased clot formation, which poses a risk of blood vessel occlusion, while an insufficient platelet count poses a risk of prolonged bleeding.
What are the symptoms of high platelet count?
Platelet hyperplasia refers to the presence of more than the normal number of platelets per unit volume of blood. This condition is not always associated with disease, but it is a warning sign and requires additional testing.
In most cases of thrombocytosis, there are no symptoms and the condition is discovered during a routine blood test. However, when the platelet count is critically high, specific complaints and manifestations may develop:
- Pain, redness, swelling in the extremities - in case of deep vein thrombosis of the extremities; chest pain and difficulty breathing - in case of pulmonary embolism
- Headache, dizziness, blurred vision, general weakness or numbness of the extremities – in thromboembolic conditions of the central nervous system
- Symptoms characteristic of peripheral circulatory disorders – tingling, burning, a feeling of ants running in the limbs
- Bleeding from the nose, gums, and skin that is prone to bruising
- Terminated pregnancies – due to thrombosis of placental blood vessels
- General symptoms - general weakness, weight loss, mild fever
The presence of symptoms is related to the type of thrombocytosis and the risk of complications. Despite the absence of symptoms, laboratory findings of very high thrombocytosis almost always require intervention and treatment.
Types of thrombocytosis
Primary thrombocytosis It is the result of excessive platelet production by bone marrow megakaryocytes, without any external causes.
- This condition is classified as a chronic myeloproliferative disease.
- It progresses slowly and remains asymptomatic for a long time.
- High platelet counts increase the risk of stroke, heart attack, and peripheral thromboembolic disease.
- In some cases, paradoxical bleeding develops – due to abnormalities in platelet function.
Diagnosis is based on coagulation and genetic tests (to detect mutations) and bone marrow biopsy.
Secondary thrombocytosisIt is a condition in which excessive platelet production occurs in response to some pathological process in the body. The incidence of secondary thrombocytosis is much higher than that of primary thrombocytosis.
The causes of secondary thrombocytosis are:
- Acute and chronic infections
- Chronic inflammation (rheumatoid arthritis, inflammatory bowel disease)
- Trauma and surgical intervention
- Acute or chronic hemorrhage (bleeding)
- Iron-deficiency anemia
- Splenectomy (removal of the spleen)
- Reactions to medications
In most cases, after eliminating the causative cause, the platelet count returns to normal. Unlike primary thrombocytosis, the risk of complications in secondary thrombocytosis is much lower, although in the presence of additional risk factors (old age, cardiovascular diseases, prolonged immobility, etc.) they may still develop.
Diagnosis of thrombocytosis
Diagnosis of thrombocytosis is based on identifying the cause that caused the increase in the number of platelets. Laboratory diagnostics begins with routine blood coagulation tests. It is necessary to exclude anemia as one of the possible provoking factors of thrombocytosis. If necessary, genetic studies are prescribed to identify variants of primary thrombocytosis.
Thrombocytosis in children
Thrombocytosis in childhood is mainly secondary or reactive in nature, mainly related to processes occurring in the body (chronic or acute infection, inflammation, iron deficiency anemia, trauma, surgery, etc.), and after the causative pathology is resolved, the platelet count returns to normal.
Moderate thrombocytosis can be asymptomatic in children as well as in adults, and only in severe cases (with an extreme increase in platelet count) do thromboembolic complications develop.
Diagnosis of the condition is based on a complete blood count and coagulation tests. It is necessary to identify the cause/disease causing thrombocytosis and treat it promptly.
In addition to treatment measures, it is important to follow general recommendations that affect blood cell counts:
- balanced nutrition
- Moderate physical activity
- Eliminating or minimizing alcohol and tobacco use
- Chronic disease control
- Periodic preventive examinations
Is it possible for an elevated platelet count to return to normal on its own?
It depends on the cause of the thrombocytosis.
How does pregnancy affect thrombocytosis?
During pregnancy, the number of platelets also increases physiologically, which is due to hormonal changes and the body's increased adaptive needs.
The study of platelet count is part of routine pregnancy monitoring studies. As a rule, during pregnancy, the platelet count decreases moderately, a critical increase in platelet count is rare (associated with pathologies of other coagulation factors and in many cases has a genetic nature).
Laboratory "Synevo" offers coagulation studies:
| Name of the test | Category | Price | CODE | Response time (working day) ** | Location of the analysis **** | Buy | hf:tax:product_cat |
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Source:
https://my.clevelandclinic.org/health/diseases/13350-thrombocytosis
https://www.mayoclinic.org/diseases-conditions/thrombocytosis/symptoms-causes/syc-20378315
