Overview

Platelets are components of blood that aid in the formation of blood clots. Thrombocytosis arises when the body produces an excessive number of platelets. When this excess is triggered by an underlying condition, such as an infection, it is termed reactive or secondary thrombocytosis.

In rare cases where no apparent cause is identified, it is labeled primary thrombocythemia or essential thrombocythemia, a condition affecting both blood and bone marrow. The detection of elevated platelet levels often involves a routine blood test known as a complete blood count. It is essential to differentiate between reactive thrombocytosis or essential thrombocythemia to determine the appropriate course of treatment.

Symptoms

Individuals with elevated platelet counts may exhibit no symptoms at all. When symptoms appear, blood clots are frequently the cause. As examples, consider:

  • Headache
  • Weakness
  • Pain in the chest
  • Confusion or speech changes
  • Burning pain in the hands or feet
  • Difficulty of breathing and nausea

Extremely elevated platelet levels can lead to bleeding, resulting in:

  • Bruises
  • Mouth or gum bleeding.
  • Bleeding of the nose
  • Blood in the stool.

Causes

Within your bones resides a spongy tissue known as bone marrow, containing stem cells capable of developing into platelets, white blood cells, or red blood cells. Platelets adhere to each other, aiding in the formation of a clot that halts bleeding when a blood vessel is injured, such as during a cut. However, an overproduction of platelets can result in thrombocytosis.

Reactive thrombocytosis

This kind of thrombocytosis is more typical. It is brought on by an underlying medical issue, like:

  • Cancer.
  • Infections.
  • Spleen removal.
  • Iron deficiency.
  • Traumas and surgeries.
  • Blood loss.
  • Hemolytic anemia — a form of anemia where the body creates less red blood cells than it can destroy, usually as a result of autoimmune disorders or specific blood diseases.
  • Inflammatory conditions such inflammatory bowel disease, sarcoidosis, and rheumatoid arthritis.

Essential thrombocythemia

The exact cause of this condition remains unclear, but it often appears to be associated with changes in specific genes. In thrombocytosis, the bone marrow produces an excessive amount of cells responsible for platelets formation, often resulting in dysfunctional platelets. Unlike reactive thrombocytosis, this form carries a higher risk of clotting or bleeding complications.

Diagnosis

If your platelet count is excessively high, a blood test known as a Complete Blood Count (CBC) can reveal this. Blood testing might also be necessary to look for:

  • Undiagnosed cancer
  • Indicators of inflammation
  • Abnormal iron levels, whether high or low
  • Gene mutations

Additionally, you might require a needle procedure to take a tiny sample of your bone marrow for analysis.

Treatment

Reactive thrombocytosis

The cause of this condition determines the course of treatment.

  • Blood loss. Your increased platelet count may go down on its own if you’ve recently undergone surgery or an injury that caused significant blood loss.
  • Infection or inflammation. Your platelet count will probably stay high if you have an inflammatory disease or a chronic infection until the condition is under control. Once the problem is identified and addressed, your platelet count should normally return to normal.
  • Spleen removed. You may develop thrombocytosis for the rest of your life if you had your spleen removed, but treatment is not likely to be necessary.

Essential thrombocythemia

Individuals with this condition who are asymptomatic typically do not require treatment. If you are at risk of blood clots, you might need to take a daily, low-dose aspirin to help thin your blood. However, do not take aspirin without consulting your doctor first.

You might need prescription medication or procedures to lower your platelet counts if you:

  • Are above 60 years old.
  • Have a history of bleeding and blood clots.
  • Have heart disease risk factors.
  • Possess a very high number of platelets.

Platelet-lowering medications such as hydroxyurea, anagrelide, or interferon alfa may be prescribed by your doctor.

In emergencies, a machine can filter platelets from your blood, a procedure known as plateletpheresis. However, the effects are temporary.

Doctors who treat this condition