Update: January 2019
Complete blood count involves first counting
the main blood cells are red blood cells, white blood cells and platelets. For
All of them have quantitative norms. Going beyond these norms
always requires clarification of the reasons. Platelets are an essential component.
our blood. Change their number as a decrease
(thrombocytopenia), and upwards (thrombocytosis) –
alarming and sometimes deadly symptom.
What are platelets
Platelets belong to one of the three main groups of shaped
blood elements. These are not true cells, but so-called blood cells.
plates – fragments of the cytoplasm of megakaryocytes (giant
multi-core bone marrow cells).
These pieces of cells enter the bloodstream and perform there.
its main function is to stop bleeding if damaged
small and medium vessels (primary vascular hemostasis).
The normal number of platelets in the blood varies from
150 до 420 Х/л.
If damage to the vascular wall occurs, platelets
activated: they increase in size, they appear
shoots. Activated plates are able to stick like
vessel wall, and to each other. Platelets glued together
form a blood clot, bleeding stops. When superficial
skin wounds it occurs within 3-5 minutes.
In the analysis performed on the hemoanalyzer, platelets
designated PLT (Platelets). Reducing the number of blood
plates dangerously spontaneous bleeding. But it also happens that
blood platelets are elevated. This condition is also
alarming and requires clarification of the cause. The number of these cells is higher
450X / L is called thrombocytosis or thrombocythemia.
Causes of elevated platelets
There are 3 forms of thrombocytosis:
- Семейный, то есть наследственный тромбоцитоз,
extremely rare. This is a mutation of the gene responsible for
the production of thrombopoietin, i.e. the hormone that stimulates
- Первичный тромбоцитоз – это ускорение
megakaryocytic sprout in the bone marrow. This is usually
tumor. This includes some leukemias, myelodysplastic
syndromes, erythremia, essential thrombocythemia. Primary form
thrombocytosis makes up 10-15% of all cases, and it is found
mainly in persons older than 60 years.
- Вторичные формы (около 80%) составляют
the largest share in the structure of thrombocytosis. Other them
name – reactive, that is, elevated platelets are
a reaction to some other, non-tumor disease. Causal
factors (eg, inflammation) result in cytokine release,
which indirectly increase the production of blood
Usually, if platelets are elevated, the reasons for this may be
- Bacterial, viral or parasitic infections. Especially this
the phenomenon is common in children during the recovery phase.
- Inflammation – for example, rheumatoid arthritis, vasculitis,
collagenosis, inflammatory bowel disease.
- Burns, injuries.
- Fluid loss in diarrhea, vomiting – relative
- Tumors (intestinal cancer, lung cancer, endometrium, kidney, cervix
uterus). Recent studies by British scientists have shown that
elevated platelet levels in many cancer patients
may be the first sign of cancer, and appears long before
the tumor will be detected by other methods.
- Blood loss, hemolytic or iron deficiency anemia.
- Nephrotic syndrome.
- Condition after surgical removal of the spleen.
- Aspleniya – spleen is, but does not function from birth.
- Compensatory leap after treatment with chemotherapy drugs, iron,
Secondary thrombocytosis disappears after treatment of the main
What is the danger of increasing platelet levels?
What do elevated platelets say? Increase in blood
plates leads, on the one hand, to increased thrombosis,
and on the other, oddly enough, to bleed. This is due to the fact
that there are a lot of platelets in the blood, but sometimes they are not enough
matured in order to properly perform their functions by
blood coagulation. The mean platelet volume is also
tall, young forms prevail.
Or the second reason – against the background of constant thrombosis.
excessive consumption of coagulation factors occurs and
the so-called DIC. Therefore, in some patients thrombocytosis
will be manifested by venous or arterial thrombosis, in others – spontaneous
bleeding, and in the third – and so on. But I must say that
such severe complications are still rare, they occur
at the level of platelets above 1500 X / l in patients with tumor
How does thrombocytosis
Elevated platelets in the blood may not manifest
clinically, even if their level reaches 1000 H / l. Usually this
detected by chance on a blood test for another reason and
is a signal to the survey. At least – recount
PLT in a smear under a microscope.
Первичный тромбоцитоз можно заподозрить, если
there is any combination of the following symptoms and if not
obvious cause of reactive thrombocytosis:
- Enlarged liver and / or spleen.
- Anemia, leukocytosis is detected in the blood.
- Symptoms of erythremia – an excess of red blood cells, hemoglobin.
- Family history.
- Стойкий (> 3 мес) thrombocytosis.
Non-specific symptoms may occur:
- Burning pain in limbs (erythromelalgia).
- Increased sweating.
- Muscle cramps.
- Dizziness, memory loss.
- Transient disturbances of consciousness (syncope).
With an increase in the number of platelets above 1000 X / L,
- Thrombosis and thrombophlebitis of the lower extremities.
- Blue and gangrene of the fingers.
- Strokes, heart attacks.
- Thrombosis of arteries of the extremities (sharp pain, numbness, cold snap
- Pulmonary embolism.
- Thrombosis of the portal or splenic vein.
- Gastrointestinal bleeding.
- Hemorrhages in the eyes, gums, skin, joints.
- Hematuria is blood in the urine.
- In pregnant women – miscarriages, bleeding.
Secondary thrombocytosis has no such pronounced clinical
symptoms as primary. Thrombosis and bleeding with him
Examination algorithm, if platelets are elevated in an adult:
- Убедиться, что not ошибки при подсчете. Repeat the analysis.
There is the concept of false thrombocytosis, when hemoanalyzer
takes for fragments of platelets destroyed red blood cells.
- Search for the cause, as the secondary
(реактивный) thrombocytosis. In this case, blood can often be found
increased C-reactive protein, ESR, leukocytes, fibrinogen.
- Conduct an ultrasound examination of the abdominal organs with
mandatory assessment of the size of the spleen.
- Examined for chronic infections, cancer
diseases, autoimmune diseases.
- During the survey, repeat the PLT count in several times.
dynamics (increases or decreases).
- If there are signs of blood disease – an enlarged spleen,
anemia, leukocytosis, erythrocytosis, blast cells – should immediately
suspect primary thrombocytosis and bone marrow analysis
Thrombocytosis in children
Elevated platelets in children (more than 500 X / L) occur
quite often: in 13% of newborns, 36% of children in the first month of life
and in 13% during the first year of life (in adults, this symptom
happens only in 1%). Then their level gradually decreases and
average to 11 years, the incidence of thrombocythemia in children and
adults are no different.
У детей преобладает вторичный thrombocytosis. Most frequent
causes are viral and bacterial infections as well
Usually 2-3 months after the treatment of the underlying disease
the level of the blood plate comes back to normal. If platelets
elevated in a child steadfastly, not diminished after treatment of anemia or
infection can be suspected hereditary or primary
thrombocytosis. Иногда для диагностики требуется геnotическое
Treatment with elevated platelets
Treatment tactics will depend on the cause. With tumors
cytotoxic drugs are used in the hematopoietic system.
Patients with essential isolated thrombocytosis and
the absence of symptoms is sometimes just observed, they are assigned
aspirin only to reduce the risk of blood clots, and correction
There are risk groups when special treatment is prescribed,
- Persons over 60 years old
- The number of PLT above 1500 X / l in young women.
- Already transferred thrombosis or bleeding.
- Patients with atherosclerosis, ischemic heart disease, hypertension.
Возможные варианты лечения включают гидроксимочевину,
анагрелид и препараты интерферона-альфа.
Тромбоцитоферез применяется как экстренный
method for bleeding, as well as before urgent surgery.
The prognosis for secondary thrombocytosis is favorable, with primary
– зависит от злокачественности опухоли костного the brain.
In any case, a patient with elevated platelets in the blood should
соблюдать следующие рекомендации:
- Waiver of alcohol and smoking.
- Follow a diet low in fat and sweets.
- Regular exercise.
- Normalization of blood sugar if there is diabetes.
- Reducing cholesterol with prescribed medications and
- Taking aspirin at a dose of not less than 75 mg per day.
- When aspirin intolerance is given clopidogrel or
ticlopidine. Reception is sometimes recommended for pregnant women.
- A sufficient amount of red should be included in the diet.
meat, green vegetables, dairy products. Fresh juices are helpful.
(pomegranate, orange, lemon), diluted with water 1: 1,
- From folk remedies, it is recommended to take garlic tincture,
crushed ginger with honey, hirudotherapy (treatment with leeches).