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Thrombocytosis

Etiologic Analysis of 663 Patients

Department of Pediatrics, King Saud University

Kamal E. Higgy

Department of Hematology, King Saud University

Shihab A. Al-Mashhadani

Department of Hematology, King Saud University

Cheruppolil R. Santhosh-Kumar

Department of Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Six hundred sixty-three children aged 1 to 16 years with thrombocytosis (defined as a platelet count of more than 500 X 10⁹/L) seen in a university hospital over a 1-year period were studied prospectively for etiology. The causes of thrombocytosis were infection (30.6%), hemolytic anemia(19.3%), tissue damage (15.2%), rebound thrombocytosis (14.8%), chronic inflammation (4.1 %), renal disorders (4.1 %), and malignancy (2%). Thrombocytosis associated with multiple, simultaneous causative factors was seen in 3.3% of cases. Among all patients with infections, osteomyelitis and septic arthritis were associated with higher platelet counts than other infections (P<. 0001). Thrombocytosis secondary to infections was significantly more common in children under 5 years of age, whereas chronic inflammation, malignancy, and renal disorders were more common causes of thrombocytosis in children over 5 years of age. Thrombocytosis of 1 million or more platelets was seen in 13 (2%) children. No thrombocytosis-related complications were seen in any children, and none required any specific treatment. Thrombocytosis is a frequent finding in children. It is due to a variety of etiologic factors and is of little clinical discriminatory value. It is often due to an acute-phase phenomenon in response to infection, tissue damage, blood loss, or anemia, and is rarely due to malignancy.

Clinical Pediatrics, Vol. 33, No. 6, 340-343 (1994)
DOI: 10.1177/000992289403300605


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