Study of Etiological Factors of Thrombocytosis

STUDY OF ETIOLOGICAL FACTORS OF THROMBOCYTOSIS Dr. Manish Kumar Jangir1, Dr. Rambabu Sharma2 Department of pediatrics, SMS Medical college, Jaipur (Rajasthan, india) Background and Aims: Thrombocytosis is classified according to origin as either essential (Primary) or reactive (Secondary). Essential thrombocytosis develops as a result of either a clonal bone marrow disorder or an abnormality in the biology of thrombopoietin. Secondary thrombocytosis is due to a variety of underlying conditions. Short lived secondary thrombocytosis is observed in conditions such as acute bleeding, trauma, major surgical procedures or after severe physical exertion. In contrast, secondary thrombocytosis associated with malignancy, chronic infection, iron deficiency or chronic inflammatory diseases may persist for a longer time. The distinction between clonal (essential) and reactive thrombocytosis is clinically relevant because the first is associated with thromboembolic and hemorrhagic complications, while the latter is not. To find out the etiological factors associated with thrombocytosis. Methods: After obtaining ethical committee approval, a hospital based, cross sectional observational case study was conducted. After applaying inclusion and exclusion criteria, a total of 152 patients were enrolled. A 2 ml sample of a fresh whole blood of EDTA-K2 Anti coagulated was collected. The sample in the EDTA were transported manually at room temperature to the laboratory and analyzed to determine Platelets, between one to three hours after sampling using Sysmex KX 21 cell counter. High Platelet counts were confirmed by repeating the test at 48 hours later. After two sequential high Platelet counts, a peripheral blood smear examination of study subject done to reconfirm high Platelet count by a qualified faculty of Pathology department posted in hematology lab. Results: In present study out of 152 childrens, 151 (99.34 %) children have secondary thrombocytosis while 1 (0.66 %) children have primary thrombocytosis. Respiratory system disease having secondary thrombocytosis were 52 (34.44 %), gastro-intestinal system disease having secondary thrombocytosis were 33 (21.85 %), central nervous system disease having secondary thrombocytosis were 23 (15.23 %) and renal system disease having secondary thrombocytosis were 18 (11.92 %), infectious disease having secondary thrombocytosis were 12 (7.95 %), Hematological system disease having secondary thrombocytosis were 6 (3.97 %), systemic disease were 5 (3.32 %), endocrine disease 1 (0.66 %), biotinidase deficience 1 (0.66 %). Respiratory diseases were the commonest cause of secondary thrombocytosis in children. Conclusions: In our study almost all thrombocytosis cases were having secondary thrombocytosis (reactive), only 1 case have primary thrombocytosis. Four common systems in children having secondary thrombocytosis were respiratory system (34.44 %), gastro-intestinal system (21.85 %), central nervous system (15.23 %) and renal system (11.92 %). Respiratory diseases were the commonest cause of secondary thrombocytosis in children.