Thrombocytosis: Symptoms, Causes And Treatment

Thrombocytosis is a disease of the bone marrow and blood that affects around two to three people in 100,000. Usually women over 50 are affected. Today you will learn interesting facts about this disease, its causes, symptoms and treatment options. 

The  thrombocytosis  is a disorder caused by an excessive number of thrombocytes (platelets) in the blood. The normal values ​​are between 150,000 and 450,000 platelets per microliter of blood. If the values ​​are slightly different, this is still normal. But when the number of blood platelets rises sharply, it is called thrombocytosis.

The platelets are produced in the bone marrow using megakaryocytes. The platelets are the smallest cells in the blood and have neither nuclei nor genetic information. They are irregular in shape and play an important role in blood clotting to stop bleeding.

So thrombocytosis is a disease of the bone marrow and blood. High platelet counts can cause serious health problems, such as a heart attack or stroke.

What types of thrombocytosis are there?

There are basically two types of thrombocytosis: the primary or essential and the secondary. In essential thrombocytosis, the bone marrow makes too many platelets, but the exact cause is unknown. Secondary thrombocytosis is caused by other diseases, for example infections, cancer, anemia, etc.

Another way of classifying this disease is:  congenital, acquired, or pseudothrombocytosis. Congenital thrombocytosis follows an inherited pattern that is present at birth. The acquired is divided into two groups:

• Primary thrombocytosis is the same as essential  and is called myeloproliferative neoplasia. It is caused by genetic abnormalities, but in many cases the exact causes of the disease are unknown.
• Secondary or reactive thrombocytosis  arises as a result of other diseases. This type of thrombocytosis is present in 85% of cases, with over half of patients suffering from it due to infections.

The  Pseudothrombozytose corresponding false positive cases. Under certain circumstances, cytoplasmic fragments can be mistaken for platelets, leading to a misdiagnosis.

Symptoms caused by thrombocytosis

In most cases there are no symptoms of this disease. It is often discovered by accident when a blood test is done for other reasons. However, with primary thrombocytosis, headache or chest pain, dizziness, weakness, loss of vision or seeing spots can sometimes occur.

Also,  fatigue, night sweats and weight loss are frequent consequences. The clinical suspicion increases if there is a miscarriage in the first trimester of pregnancy, and also in splenomegaly (enlarged spleen), bleeding, or high blood pressure.

Erythromelalgia (peripheral neurovascular vascular disease) is also characteristic of essential thrombocytosis .  With this widening of the arteries in the hands and legs, the body temperature in the extremities increases and those affected suffer from itching, pain and erythema.

Causes of Thrombocytosis

Everything indicates that essential thrombocytosis is caused by an acquired somatic mutation and is not inherited.  In 50% of the cases there is a mutation in the JAK2 genes. Often there is also a mutation in the CARL gene. In addition, cases with mutations in the genes MPL, THPO and TET2 could be detected.

Some of these genes are responsible for making proteins that are essential for blood cells to divide, especially platelets. The mutation is believed to cause the symptoms of essential thrombocytosis, but the exact process is not yet known.

Also, there are many cases where there is no mutation. The causes of the primary type in this case are unknown. The secondary type can be traced back to diseases, as we mentioned earlier.

treatment

Essential thrombocytosis does not require treatment as long as the disease is stable and there are no symptoms. In some cases, your doctor may recommend taking aspirin every day to prevent blood clots from forming. 

If there is a family history or another justified risk of cardiovascular disease, the doctor usually prescribes medication to reduce the number of blood platelets. This is also recommended if the patient is over 60 years old or if platelet counts exceed one million.

If it is of the secondary type, treatment is to treat  the underlying disease that causes the thrombocytosis.  A procedure known as thrombocitapheresis is only used in emergencies. This consists of filtering the blood, similar to what is done with dialysis.