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Original ArticleOpen Access
Etiology and Incidence of Thrombotic and Hemorrhagic Disorders in Thai Patients with Extreme Thrombocytosis
Chuncharunee S 
,
Archararit N ,
Ungkanont A ,
Jootar S ,
Angchaisuksiri P ,
Bwryaratavej A ,
Rojanasthein S ,
Atichartakarn V
,
Archararit N ,
Ungkanont A ,
Jootar S ,
Angchaisuksiri P ,
Bwryaratavej A ,
Rojanasthein S ,
Atichartakarn V NAPAPORN ARCHARARIT, M.Sc.**,
SAENGSUREE JOOTAR, M.D.*,
AHNOND BUNYARATAVEJ, Ph.D.***,
VICHAI ATICHARTAKARN, M.D.*
A retrospective study of 126 patients with extreme thrombocytosis (defined as a platelet
count
~1,000
x 109
/L)
was performed during a five-year period (June 1994-June 1999). The aim
of this study was to determine the etiology and to evaluate the clinical consequences of
extreme thrombocytosis. Seventy patients (55.5%) had reactive thrombocytosis (RT) with an age
range of 43
เธ‘
2.2 years, 56 (44.5%) had chronic myeloproliferative disorders (MPD) with an
age range of 53
เธ‘
2.4 years. Underlying causes of RT were malignancy (25170 or 35.7%), infec-
tion (16170 or 22.9%), postsplenectomized B-thalassemia/Hb E (11/70 or 15.7%), inflammation
(12170 or 17.1%), iron deficiency anemia (6170 or 8.6%). Duration post splenectomy in our B-tha-
lassemia/Hb E patients ranged from 4 months to 21 years, with a median of lO years. Subtypes of
our MPD cases were chronic myeloid leukemia (30/56 or 53.6%), essential thrombocytosis
(18/56 or 32.1%), polycythemia vera (4/56 or 7.1%), agnogenic myeloid metaplasia (3/56 or
5.4%) and unclassified MPD (1156 or 1.8%). Bleeding and thrombotic tendency were respec-
tively noted in 7 (12.5%) and 2 (3.6%) of MPD patients. Two patients of the MPD group (3.6o/r)
experienced both bleeding and thrombotic episodes. One patient (1.4%) of the RT group developed
vasculitis-associated thrombosis. However, none of the patients in the RT group had bleeding com-
plications. Extreme thrombocytosis was not a rare condition in a university hospital population,
and bleeding and/or thrombotic complication was more common in the MPD group.
Key word : Extreme Thrombocytosis, Chronic Myeloproliferative Disorder (MPD), Postsplenec-
tomized B-thalassemia/Hb E, Reactive Thrombocytosis (RT), Thrombotic,
Hemorrhagic.
SAENGSUREE JOOTAR, M.D.*,
AHNOND BUNYARATAVEJ, Ph.D.***,
VICHAI ATICHARTAKARN, M.D.*
A retrospective study of 126 patients with extreme thrombocytosis (defined as a platelet
count
~1,000
x 109
/L)
was performed during a five-year period (June 1994-June 1999). The aim
of this study was to determine the etiology and to evaluate the clinical consequences of
extreme thrombocytosis. Seventy patients (55.5%) had reactive thrombocytosis (RT) with an age
range of 43
เธ‘
2.2 years, 56 (44.5%) had chronic myeloproliferative disorders (MPD) with an
age range of 53
เธ‘
2.4 years. Underlying causes of RT were malignancy (25170 or 35.7%), infec-
tion (16170 or 22.9%), postsplenectomized B-thalassemia/Hb E (11/70 or 15.7%), inflammation
(12170 or 17.1%), iron deficiency anemia (6170 or 8.6%). Duration post splenectomy in our B-tha-
lassemia/Hb E patients ranged from 4 months to 21 years, with a median of lO years. Subtypes of
our MPD cases were chronic myeloid leukemia (30/56 or 53.6%), essential thrombocytosis
(18/56 or 32.1%), polycythemia vera (4/56 or 7.1%), agnogenic myeloid metaplasia (3/56 or
5.4%) and unclassified MPD (1156 or 1.8%). Bleeding and thrombotic tendency were respec-
tively noted in 7 (12.5%) and 2 (3.6%) of MPD patients. Two patients of the MPD group (3.6o/r)
experienced both bleeding and thrombotic episodes. One patient (1.4%) of the RT group developed
vasculitis-associated thrombosis. However, none of the patients in the RT group had bleeding com-
plications. Extreme thrombocytosis was not a rare condition in a university hospital population,
and bleeding and/or thrombotic complication was more common in the MPD group.
Key word : Extreme Thrombocytosis, Chronic Myeloproliferative Disorder (MPD), Postsplenec-
tomized B-thalassemia/Hb E, Reactive Thrombocytosis (RT), Thrombotic,
Hemorrhagic.
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