In thrombocytosis, the platelets in human blood are greatly increased for a short time and temporarily. Thrombocytosis occurs, for example, in response to blood loss or inflammation. Treatment is given on a case-by-case basis, depending on the cause, and may include, for example, the administration of ASA.
What is thrombocytosis?
The platelets in human blood are also known as thrombocytes. Platelets are formed by the strangulation of megakaryocytes in the bone marrow and have a lifespan of between five and twelve days stated. Old platelets are degraded within the spleen, liver and lungs. Platelets are equipped with enzymes of glycolysis. They contain elements of the pentose phosphate cycle, the respiratory chain, and the citrate cycle. In addition, platelets can release the so-called arachidonic acid from their cell membrane. In the circulating blood, only inactive platelets are present, which are activated by surface contact. Activated platelets release substances to stop bleeding and close an injury by adhesion and aggregation. A transient increase in the number of platelets in human blood is known as thrombocytosis. The number of blood elements increases beyond 500,000/µl in thrombocytosis. Thrombocytosis must be distinguished from thrombocythemia, in which platelets increase over the long term. In contrast, thrombocytosis is a reversible increase that is severely limited in time.
Causes
The causes of thrombocytosis can be of various types. For example, a short-term increase in platelet count may correspond to a reactive change in the blood count, as occurs in the context of diseases of the hematopoietic system, after splenectomies, or after major blood loss. For this reason, for example, patients after operations are frequently affected by this phenomenon. However, the platelet count of the blood can also temporarily increase in the course of infections or tumor diseases. Cytostatic chemotherapy, chronic iron deficiency and chronic inflammatory diseases can also result in temporary thrombocytosis. Thrombocytosis in the context of myeloproliferative diseases must be distinguished from these causes. In these diseases, there is an increased proliferation of the cells. This is referred to as primary thrombocytosis or essential thrombocythemia, which results in a strong proliferation of platelets in the blood. When it comes to causes such as severe blood loss, opinions differ on how to deal with it.
Symptoms, complaints, and signs
Patients with thrombocytosis show an increased concentration of platelets in the blood. Platelet counts physiologically make up a certain volume fraction of the blood. Typical values are ten to the power of three/µl and ten to the power of nine/l. In patients with thrombocytosis, the values are above 500,000/µl. An important feature of thrombocytosis is that it is merely a transient and usually short-term increase in platelets. This increase is itself a symptom and cannot be considered a disease in the strict sense. An extremely elevated platelet count can promote thrombosis, depending on the cause. The accompanying symptoms of thrombocytosis depend on the primary cause. For example, if high blood loss has occurred, shock to hemorrhagic fever may be present. In such situations, thrombocytosis with levels up to more than 1,000,000 per µl is a natural body response.
Diagnosis and course of the disease
The diagnosis of thrombocytosis is made by laboratory diagnosis. In this context, a platelet count of 500000 per centiliter of blood is considered a guideline for diagnosis. The increase in platelets is usually attributed to a specific cause within the diagnostic process. The cause may be clear after operations or accidents and then requires no further clarification. In less clear cases, further clarification of the cause must take place, which may require clinically extensive examinations. The prognosis of patients depends on the particular cause of the increase.
Complications
Thrombocytosis need not lead to serious symptoms or to severe complications in every case. If the symptom occurs for only a short time, it usually does not need to be treated and no further symptoms will occur.However, thrombocytosis can also lead to a severe fever and must be treated in this case. If the symptoms persist for a long time, causal treatment of this disease is also necessary to prevent further complaints and complications. Especially after an accident or after an operation this complaint can occur and must be examined and treated here. Since blood loss is usually stopped quickly after an accident, the symptoms of thrombocytosis disappear again on their own. Treatment of thrombocytosis can be done with the help of medications and usually takes place without complications. With the help of blood thinning agents, the symptoms can be relatively well alleviated and limited. Further complications do not occur. The life expectancy of the patient is also not limited by the disease. However, if internal bleeding occurs, further surgical interventions are necessary to stop it.
When should you see a doctor?
The affected person is definitely dependent on treatment by a doctor in case of thrombocytosis. There can be no self-healing in this disease, so a visit to a doctor is essential. If treatment is not received, symptoms usually continue to worsen and significant complications occur. In most cases, thrombocytosis is detected during a blood test. A doctor should be consulted if the blood value exceeds the corresponding maximum value and should therefore be checked. However, this overshoot may only occur for a short period of time, so a retest should usually be performed to confirm the suspicion. Thrombocytosis can be detected by a general practitioner. Furthermore, a severe fever can also indicate thrombocytosis and should then be examined by a physician if it lasts for a long time and does not disappear on its own. Thrombocytosis is treated by a general practitioner or by an internist. The treatment itself depends on the exact cause of the disease.
Treatment and therapy
Thrombocytosis is usually treated causally. This means that the primary cause of the increase in platelets is defined and, if possible, eliminated. If the cause cannot be eliminated, drug solutions are available to reduce the platelet count. However, in the context of certain causes, there is controversy as to whether such intervention is even useful. Especially after large blood losses, many scientists consider the naturally reactive overproduction of platelets to be a phenomenon that does not require drug intervention. Other scientists consider drug intervention necessary even in these cases and fear thrombosis as a possible complication of the increased platelet count despite the blood loss. In drug intervention, patients are usually given ASA. This is acetylsalicylic acid, which is a widely used analgesic, anti-inflammatory, and antipyretic drug. In addition, ASA can act as an antiplatelet agent. ASA reduces the risk of thrombosis by exerting a blood-thinning effect. However, its administration in cases of internal bleeding, for example, is counterproductive, since thinning the blood in this context could contribute to the patient bleeding to death. Therefore, the agent is not administered after accidents in most cases. However, in thrombocytoses of other causes, treatment with AAS is among the most common therapeutic steps.
Prevention
Thrombocytoses can have many causes. They can be prevented only to the extent that their causes can be prevented. Thus, for example, all preventive steps related to high blood loss and inflammatory phenomena are considered preventive measures. Since chronic iron deficiency also increases the platelet count, taking sufficient iron is also a preventive measure.
Follow-up
In thrombocytosis, there are usually few and usually limited measures of follow-up care available. The affected person should therefore consult a physician at the first symptoms of this disease to avoid complications or other complaints in the further course. An early diagnosis with subsequent treatment usually has a very positive effect on the further course of the disease.In most cases, thrombocytosis results in various malformations in the child, so that he or she is dependent on intensive care in his or her daily life. As a rule, thrombocytosis cannot be treated during pregnancy, so that the various malformations and deformities can only be corrected after the birth of the child. Most of those affected are usually dependent on surgical intervention, which can alleviate the symptoms. The earlier this intervention takes place, the better is usually the further course. After such an operation, it is important to refrain from exertion or from stressful and physical activities. As a rule, this disease does not reduce the life expectancy of the affected person.
What you can do yourself
Thrombocytosis usually does not require treatment. In most cases, the number of platelets in the blood is only slightly elevated and there are no symptoms. Treatment is needed if the platelet count is severely elevated, as this can cause a disturbance in blood circulation. In addition, the cause of the thrombocytosis must be clarified. The patient can contribute to this by informing the physician about previous illnesses and risk factors. If the symptoms occur after acute bleeding or surgery, the physician must be consulted. In the case of severe infections, self-treatment is also not recommended. The trigger must be eliminated before the symptoms are treated in the long term. Patients suffering from rheumatic diseases or chronic inflammatory bowel disease should consult the doctor. Self-treatment is not advisable in this case either. In addition, various general measures are useful. Because the imbalance of the blood platelets can lead to fatigue, sparing and rest apply. The patient should lie down to sleep in case of headache or dizziness. Cooling compresses help with severe nosebleeds. Night sweats are best remedied by an optimally air-conditioned bedroom. Exercise and massages help with calf cramps. Bleeding gums as well as vision problems should be treated by a doctor.
