Causes and risk factors
Thrombocytosis is of two types – primary and secondary. Primary Thrombocytosis is also called as essential Thrombocytosis. It is caused when abnormality in the bone marrow leads to increase in number of platelets. The exact cause is unknown. Secondary Thrombocytosis is caused as a result of an underlying medical condition such as iron deficiency anaemia, haemolytic anaemia, cancer, inflammation or infection due to diseases like inflammatory bowel disease, tuberculosis etc, post surgery especially spleenectomy, drug reactions. Transient increase in platelet count can be caused in some conditions like recovery from severe blood loss, recover from conditions leading to low platelet count, lack of vitamin B12 or folic acid, as a response to physical activity, acute infection. The risk factors include high cholesterol, diabetes, high blood pressure, obesity, smoking, tobacco use, alcohol.
Clinical presentation
Most patients with thrombocytosis are usually asymptomatic at initial stage. Symptoms appear later. Signs and symptoms are caused due to blood clotting and bleeding. Abnormal coagulation of blood is seen. It leads to conditions like heart attack or stroke. Blood clots are formed in any organ and cause signs and symptoms like changes in speech and awareness, seizures, shortness of breath, nausea. In pregnant women it can lead to foetal growth retardation or even miscarriage. Bleeding occurs as the excess number of platelets formed, are used up by the body in process of formation of clots. Thus, no platelets are left for clotting of blood leading to bleeding. Bleeding such as easy bruising on skin, bleeding from nose, ears, gums, teeth. Bleeding can also occur in stomach and intestine. Additional symptoms include weakness, fatigue, dizziness, headache, chest pain, tingling in hands and feet.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. History of recent blood transfusion should be sought. Routine haemogram, peripheral blood smear, is performed. Bone marrow aspiration biopsy is recommended. Genetic testing is done.
Treatment
Treatment depends upon the underlying cause. Treating the underlying medical condition in case of Secondary Thrombocytosis is required. Medication to reduce platelet count are prescribed. A procedure called plateletpheresis [ to lower platelet count] may be required. Doctor will recommend lifestyle modification measures such as eating heart healthy diet, regular exercise, quit smoking, tobacco, alcohol and keep a check over blood pressure, blood sugar and cholesterol levels which contribute further to the treatment.
Other Modes of treatment
The other modes of treatment can also be effective in treating thrombocytosis. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating thrombocytosis.