Elevated platelets can indicate reactive thrombocytosis or essential thrombocythemia, which can cause blood clotting or bleeding. Doctors monitor blood chemistry to catch these conditions early. Treatment involves addressing underlying diseases or medications to reduce platelets. Essential thrombocythemia is not curable and can lead to more serious conditions.
Elevated platelets usually indicate that a person or animal is suffering from reactive thrombocytosis or essential thrombocythemia, two fairly serious blood conditions. When caught early enough, however, both are usually quite easy to deal with. There are many different factors that control blood platelet counts. Proper balance is an important part of overall health, and for this reason, doctors and other health care professionals usually monitor blood chemistry as part of routine patient checkups. Tests may also be ordered if there is any reason to suspect a platelet count problem.
Blood test basics Blood
Healthcare professionals typically use a test known as a complete blood count (CBC) to measure the number of red and white blood cells and platelets within a particular blood sample. Blood is a fairly complex substance that requires a fairly rigorous balance of elements to function properly. The number of platelets in a healthy patient ranges from 150,000 to 400,000 per microliter. When the results of a platelet count exceed this amount, the patient is considered to have elevated platelets.
Platelets, also known as thrombocytes, are the smallest component produced by the bone marrow, which is the tissue found inside bones where all blood cells are made. Platelets stick together through a process known as clumping and form clots to stop bleeding. Having too few platelets can cause excessive bruising and bleeding, but having too many is usually not much better. A patient with too many platelets can form clots too easily in veins and arteries. These can block blood flow, causing life-threatening problems that can include heart attack, stroke, or pulmonary embolism.
Reactive thrombocytosis
Reactive thrombocytosis, also known as secondary thrombocytosis, is the most common cause of increased platelets. This disorder occurs in response to other diseases or conditions. These can include chronic inflammatory conditions, acute infections, some anemias, cancer and other blood disorders. In most cases, the effects of reactive thrombocytosis are mild and usually resolve when the underlying disease or condition is adequately treated. These patients generally have platelet counts of less than 1,000,000 per microliter.
Essential thrombocythemia
A more serious cause is essential thrombocythemia (ET), also known as primary thrombocythemia. If no other precipitating condition can be found, doctors usually do a bone marrow biopsy to look for evidence of ET. This is especially true in patients with counts well approaching millions per microliter. Platelet aggregation studies to evaluate the ability of platelets to clot are also usually ordered to identify any abnormalities.
ET is a disease that originates in the bone marrow and causes an overproduction of megakaryocytes, the large cells that break down into the fragments that form platelets. The platelets produced by this faulty mechanism do not always function normally. While the patient diagnosed with reactive thrombocytosis should be alert for problems caused by excessive clotting, elevated platelets in a patient with ET can cause abnormal clotting or bleeding. As a result, it is very important that patients receive the correct diagnosis so they know what to look out for and when to worry.
Treatment options
Once a doctor has received all of the test results and had a chance to evaluate and examine the patient, they will typically make a diagnosis and outline a possible treatment plan. Much of what this plan entails will depend on the specific cause, as well as the person’s overall health and other pre-existing conditions. In most cases, treatment for reactive thrombocytosis involves treating the underlying disease first, which can be complex or relatively simple depending on the circumstances. Once this condition is resolved or relieved, platelet counts stabilize normally.
Treatment of ET is often a little more streamlined, but it can also be more unpredictable. It may consist of aspirin therapy and medications to reduce platelets or other lifestyle changes and therapies designed to restore some degree of blood balance. ET is usually not curable, and the disease predisposes a small percentage of patients to develop acute leukemia and bone marrow fibrosis. Both of these are much more serious conditions that can be life-threatening if not managed properly.
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