What Is Thrombocytosis?

Thrombocytosis is a condition of abnormalities in the high number of platelets produced by the body. In adults, the normal thrombocyte limit is 150-450 x 10 9 / L or 150,000-450,000 platelets per microliter of blood, whereas a patient with thrombocytosis may have platelet counts of up to 600 x 10 9 / L or more.

Thrombocytosis is one of the main causes of blood clotting conditions. This condition can be triggered also by other diseases that have been owned or suffered before so early examination can also determine what type of thrombocytosis experienced by patients.

Causes of thrombocytosis
Thrombocytosis can be caused by infection, bone and bone marrow disorders, or other conditions. Some types of thrombocytosis, among others:
  • Secondary thrombocytosis / thrombocytosis or reactive thrombocytosis. This thrombocytosis is generally caused by an infection or other disease that already exists or is being suffered.
  • Primary thrombocytosis or essential thrombocytosis. This thrombocytosis is caused by disorders of the bone marrow. This condition is the more common cause of blood clots. The exact cause underlying the bone marrow disorder is not known.
Secondary thrombocytosis is one of the overreacting reactions to the condition of the body and can be caused by several conditions. Among others are caused by allergic reactions, heart attacks, physical exercise, infections (eg tuberculosis), iron deficiency, vitamin deficiency, to cancer. This excessive reaction triggers the release of cytokines that lead to increased platelet production. Some other causes, including some classes of drugs, are:
  • Blood loss or severe acute bleeding.
  • Acute renal failure or other kidney organ disorders.
  • Surgery to treat coronary heart disease.
  • Surgical removal of the spleen.
  • Inflammation, such as the condition of rheumatoid arthritis, connective tissue disorders, intestinal inflammation, or celiac disease.
  • Pancreatitis.
  • New big surgery experienced.
  • Trauma.
  • Burns.
  • Hemolytic anemia. This condition can be triggered by blood or autoimmune disorders suffered by the patient.
  • Epinephrine medicine
  • Sodium heparin medicine.
  • Tretinoin medicine
  • Vincristine sulfate medicine.
Bone marrow contains stem cells ( stem cells ) that can develop into red blood cells, white blood cells or platelets (platelets). Primary thrombocytosis is caused by the number of platelets produced by the bone marrow into the blood. Excess platelet counts in primary thrombocytosis can not function normally resulting in increased risk of blood clots or bleeding. In addition to disruption of the bone marrow, primary thrombocytosis can also be caused by chronic myelogenous leukemia, myelofibrosis, and polycythemia vera. Genetic factors from parents or family members who have this condition also play a role.

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Symptoms of thrombocytosis
Symptoms of secondary thrombocytosis generally include headaches, dizziness, fatigue, chest pain, fainting, tingling in the hands and feet, or temporary visual disturbances. Not infrequently also secondary thrombocytosis shows no symptoms at all.
Symptoms of secondary thrombocytosis are commonly associated with symptoms of a trigger condition so routine blood tests or other tests will be needed to determine the diagnosis of secondary thrombocytosis.

Primary thrombocytosis is generally slightly more common in women and people over 50, although it may occur in younger people as well. Other symptoms of this condition are not much different from secondary thrombocytosis with the addition of symptoms:
  • Redness, burning pain, and pulsation in the area of ​​the hands and feet.
  • Loss of temporary vision function.
  • Enlarged spleen
  • Bleeding. Bleeding that can occur in the form of nosebleeds, bleeding gums, bruises on the skin, and dirt with blood.
Blood clots can be experienced by patients in the area of ​​the hands and feet, as well as the brain so as to cause a stroke or transient ischemic attack (TIA). Immediately see a doctor if this happens.

Diagnosis of thrombocytosis
Your doctor will ask you some questions about your condition. It is a good idea to prepare a list of questions and carry notes, such as illness, treatment procedures that have been or are being experienced, lists of allergies, medications, and symptoms of the disease at the time of examination. After that, the doctor will perform a physical examination, including analyzing the size and condition of the spleen and signs of infection or inflammation.
The doctor will perform a blood test to determine the number of your platelets. In addition, blood smear or blood smear tests may also be performed, taking a small amount of blood samples and then observing the size and movement of platelets using a microscope.

Blood tests may be performed repeatedly to ascertain whether the platelet count remains above the normal limit before the doctor gives a diagnosis. If the platelet count is proven to stay above the normal limit, then the doctor will then find out if there are other conditions that could be a trigger of thrombocytosis. Other possible tests are:
  • Signs of inflammation.
  • Check the levels of iron in the blood.
  • Genetic testing to detect conditions that cause primary thrombocytosis as well as the history of this disease in the family.
  • Perform tissue biopsy or suck fluid in bone marrow to obtain and analyze abnormal cells as well as the number of platelet producing cells called megakaryocytes.

Treatment of thrombocytosis
Secondary thrombocytosis rarely requires treatment or special procedures to reduce platelet count. The purpose of treatment of secondary thrombocytosis is to overcome the initial conditions of patients who trigger thrombocytosis. Generally the platelet count will return to normal levels after the underlying initial condition is resolved. For example, if thrombocytosis is caused by inflammation, the platelet count may drop to normal levels after the inflammation is treated.
In cases of secondary thrombocytosis triggered by removal of the spleen, the patient may experience lifelong thrombocytosis, but it is unlikely that the patient needs the drug.

Primary thrombocytosis is included in chronic conditions (long-term illness) and there is no cure. Treatment in cases of mild primary thrombocytosis can be treated without medication. However, in severe conditions, patients may be given platelet-lowering drugs, blood thinners, or both.

In patients younger and no symptoms, doctors will recommend a health check, especially blood, periodically. In older patients who have had blood clots or TIA, blood pressure, high cholesterol, and diabetes, doctors may prescribe some medications.

Drugs for thrombocytosis patients may also be accompanied by the administration of low-dose aspirin to reduce the risk of agglomeration and increased platelet count. Some of these drugs, among others:
  • Hydroxyurea. Drugs of this class function to suppress the production of blood cells, including thrombocytes, in the bone marrow. The doctor will monitor the number of blood cells and liver function of the patient during this period. These drugs have side effects that tend to be low and long-term use is not recommended as it poses a risk of myelogenous leukemia .
  • Anagrelide. Drugs from this class are not associated in increased risk of leukemia, but are also considered to be less effective for use. These drugs have side effects dizziness, headache, nausea, diarrhea, to heart disorders.
  • Interferon alpha or pegylated interferon alpha 2a. Drugs of this class are given by injection and are the best choice in some cases. These drugs have more serious side effects than the two drugs above, such as nausea, diarrhea, seizures, flu-like symptoms, to depression.
An emergency procedure may be used for post-hazard handling due to primary thrombocytosis, ie pheresis platelets . For example in patients who have a stroke or acute bleeding. A needle will be connected to a tube to drain the patient's blood to a device that will separate platelets from the blood. After that blood flowed back into the body. This procedure serves to decrease platelet counts temporarily. In primary thrombocytosis patients, especially in patients who are pregnant, regular low-dose aspirin intake may be recommended by your doctor.

Complications of thrombocytosis
Older patients with thrombocytosis have a tendency to have serious complications if not treated promptly. Patients with primary thrombocytosis in particular and people who have experienced blood clots or bleeding are also susceptible to certain complications, such as:
  1. Stroke. Blood clots can block blood flow to the brain and trigger a stroke. Also recognize the symptoms of stroke to prevent this condition and know when to get medical treatment.
  2. Heart attack. Blood clots can also block blood flow to the heart and trigger heart attacks. Also recognize heart attack symptoms, such as cold sweat-like pain, strong squeeze in the chest area, pain radiating to arms, shoulders, back, teeth or jaws.
  3. Complications in pregnancy. Thrombocytosis can cause miscarriage, so routine examination and treatment of patients with both conditions is strongly recommended.
  4. Acute bleeding with large lost blood volume.
  5. Myelofibrosis. This bone marrow disorder causes the appearance of scar tissue which then triggers acute anemia and swelling of the liver and spleen.
  6. Acute myelogenous leukemia, ie white blood cell cancer and bone marrow that develops very quickly.

Prevention of thrombocytosis
Lifestyle changes play a role in reducing the risk of developing conditions that may contribute to thrombocytosis. Take the following precautions, such as:
  • Start a healthy diet. Choose foods containing low grains, vegetables, fruits and saturated fats. Eating in portions that fit the needs of the body.
  • Maintain a normal weight to avoid the risk of increased blood pressure due to overweight. This step is also effective in preventing obesity.
  • Quit smoking. Start doing the steps to stop your smoking habit.
  • Perform physical activity on a moderate level for at least 30 minutes per day. This kind of sport can be a leisurely walk, swim for a few laps, or a leisurely bike ride in the morning.

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