True thrombocytosis?

summary

The increase of platelet count may be caused by cytokine driven (reactive) mechanism, or by the over production of growth factor independent (spontaneous) clonal / neoplastic megakaryocytes, such as myeloproliferative tumor or chronic myeloid leukemia. True thrombocytosis? Next, I'd like to share my views with you.

True thrombocytosis?

First, patients with reactive thrombocytopenia and spontaneous thrombocytopenia have primary symptoms. The onset of primary thrombocythemia is insidious, with fatigue, fatigue and other non-specific symptoms. Sometimes it is diagnosed by blood routine examination or splenomegaly.

Second, the incidence of thrombosis in patients increased, including arterial thrombosis and venous thrombosis caused by related symptoms. There are also patients with microvascular thrombosis headache, visual symptoms, erythema and limb pain. A small number of patients have bleeding symptoms, including gastrointestinal bleeding, epistaxis, gingival bleeding, hematuria and so on.

Third: 50% - 80% of patients have splenomegaly, mostly moderate, megaspleen is rare. Platelet count ≥ 450 × 109 / L, mostly in (600-3000) × 109 / L, platelet aggregation was seen on the smear, and large, abnormal or small platelets were occasionally seen. The number of white blood cells increased (10-30) × 109 / L, mainly neutrophils

matters needing attention

(1) Screening for hypertension, hyperlipidemia, diabetes and smoking history, and corresponding treatment（ 2) Except for contraindications, all ET patients were treated with aspirin（ 3) The high-risk group was treated with cytoreductive therapy, including hydroxyurea, anagrel, interferon, etc.