Skip to Main Content

Chapter 75: Reactive (Secondary) Thrombocytosis

INTRODUCTION

  • The upper limit of a normal platelet count is usually between 350 × 109/L and 450 × 109/L depending on the clinical laboratory and specific method used.

  • Table 75–1 presents the major causes of elevation of the platelet count above the normal limit.

  • Reactive thrombocytosis may persist for prolonged periods and resolve only with resolution of the underlying disorder.

  • Thrombocytosis after recovery from thrombocytopenia ("rebound") usually peaks in 10 to 14 days.

  • The platelet count after splenectomy may reach 1000 × 109/L or more within the first week and return to normal within about 2 months. Severe or persistent postsplenectomy thrombocytosis may be a result of persistent iron deficiency anemia or unmasking of primary thrombocythemia.

  • There is no convincing evidence that therapy to reduce the platelet count or interfere with platelet function is of benefit in reactive thrombocytosis, with the possible exception of severe postsplenectomy thrombocytosis in patients with persistent hemolytic anemia.

TABLE 75–1MAJOR CAUSES OF THROMBOCYTOSIS
View Table||Download (.pdf)
TABLE 75–1 MAJOR CAUSES OF THROMBOCYTOSIS

  1. Clonal thrombocytosis

    1. Primary (essential) thrombocythemia

    2. Other myeloproliferative disorders (polycythemia vera, chronic myelogenous leukemia, primary myelofibrosis)

  2. Familial thrombocytosis

  3. Reactive (secondary) thrombocytosis

    1. Acute blood loss

    2. Iron deficiency

    3. Postsplenectomy, asplenic states

    4. Recovery from thrombocytopenia ("rebound")

    5. Malignancies

    6. Chronic inflammatory and infectious diseases (inflammatory bowel disease, connective tissue disorders, temporal arteritis, tuberculosis, chronic pneumonitis)

    7. Acute inflammatory and infectious diseases

    8. Response to exercise

    9. Response to drugs (vincristine, epinephrine, all-trans-retinoic acid, cytokines, and growth factors)

    10. Hemolytic anemia

For a more detailed discussion, see Kenneth Kaushansky: Reactive Thrombocytosis. Chap. 120, p. 1929 in Williams Hematology, 8th ed.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MH Privacy Center Close