Thrombocytosis – Symptoms, Causes And Treatment

Thrombocytosis is also known as thrombocytosis. It is characterized by a significant increase in the number of platelets in humans. The normal, standard amount is between 150,000 and 450,000 per microliter of blood. Find out more about it.

If the condition is slightly above or below this then it is still perfectly normal. On the other hand, if a much higher number is indicated – we are dealing with thrombocythemia.

Platelets are produced in the bone marrow from cells called megakaryocytes. They are a type of blood fragment that has no nucleus and is characterized by an irregular shape.

They play an important role in blood coagulation which is necessary, for example, to stop bleeding. For this reason, thrombocytosis is considered a disease of the bone marrow and blood. Platelets (thrombocytes, PLT) are responsible for the proper clotting of blood.

Thrombocytopenia – its types

There are basically two types of thrombocytosis: primary (also called primary) and secondary.

• In primary thrombocytosis, the bone marrow produces platelets abnormally. This type is the result of an autonomous proliferative process. It is most common in women.
• Unfortunately, the cause is not fully known. In turn, secondary thrombocythemia is a consequence of other diseases, such as infections, cancer, anemia, etc.

Another way to classify thrombocytosis are three groups: primary, acquired (secondary), and pseudo-pseudo. In some studies, therefore, the alleged gender is also added. Congenital thrombocytosis is defined by an inheritance pattern and is present after delivery. The secondary ones, on the other hand, can be divided into two groups.

• Primary: The causes may be myeloproliferative neoplasms caused by genetic mutations. Even so, in many cases the cause remains unseen.
• Secondary or so-called acquired types of thrombocythemia are the result of other diseases. This is equivalent to 85% of the time. More than half of them are caused by any kind of infection. It can be caused by certain factors such as inflammation, iron deficiency and alcoholism.
• In contrast, pseudo-thrombocythemia corresponds to false-positive cases. There are circumstances when certain fragments of the cytoplasm are confused with platelets and lead to misdiagnosis.

Thrombocytopenia – the most common symptoms

In most cases, the disease is asymptomatic and is usually detected by accident on blood tests. Some symptoms occur with the original form.

Fatigue, night sweats, and weight loss are also quite common. Clinical suspicion is increased if there are also first trimester miscarriages, spleen enlargement, regular bleeding and hypertension.

Erythromelalgia is also very characteristic. This is the widening of the vessels in the arteries of the hands and feet, causing the extremities to increase temperature, as well as itching, pain and erythema.

The causes of thrombocythemia

The cause of the excessive production of platelets is believed to be too high sensitivity to cytokines, which increase the number of platelets. This can lead to a low sensitivity to substances that  block the production of platelets.

There are all indications that one type of thrombocytosis causes an acquired, ie non-inherited, somatic mutation. In 50% of cases there is a mutation in JAK2 genes. In another large number of cases, the CARL gene is mutated. There have also been cases of mutations in the MPL, THPO and TET2 genes.

Several of these genes are responsible for the production of proteins that are critical to the division of blood cells, and platelets in particular. The mutation is thought to induce symptoms of idiopathic thrombocytosis, but it is not yet known exactly how this happens.

On the other hand, when it comes to the secondary form, it results from the diseases and factors mentioned above (cancer, iron deficiency or alcoholism).

Thrombocytosis – possible treatment

In many cases, it does not require treatment as long as it remains stable and leaves no signs or symptoms of the disease. Occasionally, your doctor may recommend that you use aspirin every day to prevent blood clots.

• If there is a history or risk of cardiovascular disease, medications to lower your platelet count will most likely be prescribed. It is also recommended when the patient is over 60 years old or when the platelet count is over a million.
• With secondary treatment, treatment is to control the disease causing thrombocytosis.
• Only in case of emergency, a procedure called thrombocytapheresis or platelepheresis is used. It works by filtering the blood similar to dialysis.

First of all, the long-term asymptomatic course of the ailments determines a good prognosis. According to them, there is no need for cytoreductive therapy, which may have unnecessary side effects. 

Correct diagnosis

If thrombocythemia is suspected , blood and bone marrow tests are performed. Blood analysis checks for a steady increase in the thrombocyte count> 450,000 / μl and whether the platelet function may be disturbed or normal.

Otherwise, a bone marrow puncture is performed. A genetic analysis or ultrasound examination can also be performed.