Thrombocytosis is a condition when the number of platelets in the blood mexceed the normal limit.Although rare, this condition can trigger the occurrence of several serious diseases due to the formation of abnormal blood clots, such as stroke and heart attack.
Platelets or platelets are pieces of blood produced by the bone marrow. Platelets play a role in the blood clotting process. When bleeding occurs, these pieces of blood work by sticking together to form a clot, so that the bleeding stops.
In patients with thrombocytosis, the bone marrow produces excessive platelets. As a result, platelets can form blood clots that shouldn't exist. Serious problems can occur if the blood clot blocks blood vessels in important organs, such as the brain and heart.
Causes of Thrombocytosis
Based on the cause, thrombocytosis is divided into two, namely:
Primary thrombocytosis
Primary thrombocytosis occurs due to a disorder in the bone marrow, which makes the bone marrow produce excessive platelets. This condition is more common in people aged 50–70 years and women aged under 40 years.
The exact cause of the bone marrow disorder is not known. However, in some cases, this condition occurs due to genetic disorders or mutations.
Secondary thrombocytosis
Secondary thrombocytosis occurs due to a disease or other condition that causes the bone marrow to produce more platelets. These conditions include:
- Infection
- Cancer, especially lung, breast, and uterine cancer
- Iron deficiency anemia
- Hemolytic anemia
- Inflammation, such as rheumatoid arthritis and intestinal inflammation
- Surgery, especially surgery to remove the spleen
- Hemolysis or abnormal destruction of red blood cells
- Use of drugs, such as epinephrine, tretinoin, vincristine, or heparin sodium
Symptoms of Thrombocytosis
The normal number of platelets in human blood is 150,000–450,000 per microliter of blood. A person is declared to have thrombocytosis if the platelet count is above 450,000 per microliter of blood.
The increase in the number of platelets tends to rarely show symptoms. Generally, patients only find out that they have thrombocytosis when medical check-up or when the doctor performs a blood test.
However, there are also some patients who feel symptoms. Usually, the symptoms of thrombocytosis occur due to the presence of a blood clot. In each person, the symptoms felt can be different, depending on where the blood clot occurs.
The following are some of the symptoms of thrombocytosis that can appear:
- Dizziness or headache
- Chest pain
- limp body
- Tingling in hands or feet
- Visual disturbance
In some cases, when the increase in platelet levels exceeds 1 million per microliter of blood, the symptoms that can occur are bleeding. This is caused by a decrease in the quality of platelets in the blood, even though the number is very large. At this stage, symptoms that may occur include:
- Bruises on the skin
- Nosebleed
- Bleeding gums
- Bloody stools
The above symptoms are more common in primary thrombocytosis. Even so, it is possible that secondary thrombocytosis can also cause symptoms, especially if the underlying cause is not treated.
When to go to the doctor
Check with your doctor if you experience the symptoms and complaints mentioned above. Early examination and treatment of thrombocytosis will increase the chances of recovery and reduce the possibility of complications.
If you have a disease or condition that can trigger thrombocytosis, make regular checkups with your doctor. This is so that the condition you are suffering from can be monitored and treated appropriately, so that you avoid complications, including thrombocytosis.
Diagnosis of Thrombocytosis
Thrombocytosis is generally discovered incidentally during routine blood tests. In this case, the patient will be advised to undergo a series of other tests to confirm the diagnosis.
To diagnose thrombocytosis, initially the doctor will ask questions about the symptoms and complaints that the patient may experience, a history of infection, and a history of the patient's general health condition. Next, the doctor will perform a thorough physical examination.
The doctor will also perform several supporting tests to get a more accurate diagnosis. Some of these checks are:
- Peripheral blood smear test (blood smear), to see the size of platelets
- Blood clotting test
- Platelet aggregation test, to see platelet function
After the patient is known to have thrombocytosis, the doctor will run a follow-up examination to find out the cause. Some of the possible checks are:
- Bone marrow aspiration
- Test the level of iron in the blood
- Tests for markers of inflammation, such as CRP levels (C-Reactive protein)
It is important to note that an examination of the platelet count also needs to be carried out when splenomegaly is detected or there are signs of infection.
Thrombocytosis Treatment
Thrombocytosis patients who are asymptomatic and whose condition is stable only require routine examinations. Meanwhile, for patients who experience symptoms, treatment can be carried out based on the type of thrombocytosis, namely:
Primary thrombocytosis
Generally, primary thrombocytosis is treated in patients who have the following conditions:
- Over 60 years old
- Have a history of bleeding or blood clots
- Have risk factors for heart disease, such as diabetes, high cholesterol, or high blood pressure (hypertension)
Some of the treatment methods that doctors can use include:
- Administration of aspirin, to reduce blood clotting
- Administration of drugs such as hydroxyurea or interferon, to suppress the production of platelets by the bone marrow
- Procedure ppheresis latelet, to separate platelets from the bloodstream, which is done if the production of platelets cannot be rapidly reduced by medication
Secondary thrombocytosis
Treatment of secondary thrombocytosis is aimed at treating the conditions that cause thrombocytosis. By treating the cause, the platelet count can return to normal.
If the cause is an injury or surgery, the increase in platelet count usually doesn't last long and can return to normal on its own. However, if the cause is a chronic infection or inflammatory disease, the platelet count will remain high until the cause is controlled.
On the other hand, surgical removal of the spleen (splenectomy) can lead to lifelong thrombocytosis. Even so, usually no special treatment is needed to lower the platelet count in this condition.
Complications of Thrombocytosis
If not treated properly, thrombocytosis can lead to serious complications, such as:
- Bleeding a lot
- Blood clotting disorders, such as: deep vein thrombosis (DVT), stroke, pulmonary embolism, even heart attack
- Miscarriage or fetal development problems in pregnant women
Prevention of Thrombocytosis
Thrombocytosis is difficult to prevent. The best that can be done is to reduce the risk of developing conditions that can trigger thrombocytosis. This can be achieved by changing a healthier lifestyle, such as:
- Eat a balanced diet, such as vegetables or fruits
- Maintain ideal body weight
- Quit smoking
- Exercise regularly