Essential thrombocytosis natural history, complications and prognosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 4: Line 4:


==Overview==
==Overview==
If left untreated, patients with essential thrombocytosis  may progress to develop symptoms like headache, dizziness, vision disturbances, chest pain, intense burning pain in hands and/or feet ([[erythromelalgia]]), numbness and tingling of hands and feet, [[priapism]] (persistent and painful erection of the penis) and so on depending on the vessel occluded with the thrombus. Complications that can develop from essential thrombocytosis are thrombotic events ([[DVT]], cerebrovascular accidents,etc), bleeding (bruises, gum bleeds, [[epistaxis]], etc), [[acute leukemia]] and [[myelofibrosis]]. Essential thrombocytosis is associated with a good prognosis if patients are medically supervised on a regular basis. Lifespan is usually normal as any other unaffected person, though some patients may have symptoms from vascular occlusion and/or bleeding. Rarely the disease may undergo a leukemic conversion or [[myelofibrosis]].   
If left untreated, patients with essential thrombocytosis  may progress to develop symptoms like headache, dizziness, vision disturbances, chest pain, intense burning pain in hands and/or feet ([[erythromelalgia]]), numbness and tingling of hands and feet, [[priapism]] (persistent and painful erection of the penis) and so on depending on the vessel occluded with the thrombus. Common complications of essential thrombocytosis include thrombotic events ([[DVT]], cerebrovascular accidents,etc), bleeding (bruises, gum bleeds, [[epistaxis]], etc), [[acute leukemia]] and [[myelofibrosis]].<ref name = paed/><ref>{{cite journal|last=Frewin|first=R|coauthors=Dowson, A|title=Headache in essential thrombocythaemia.|journal=International Journal of Clinical Practice|date=October 2012|volume=66|issue=10|pages=976-83|doi=10.1111/j.1742-1241.2012.02986.x|pmid=22889110|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469735/pdf/ijcp0066-0976.pdf|format=PDF|pmc=3469735}}</ref><ref>{{cite journal|last=Tefferi|first=A|title=Annual Clinical Updates in Hematological Malignancies: a continuing medical education series: polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk-stratification, and management.|journal=American Journal of Hematology|date=March 2011|volume=86|issue=3|pages=292-301|doi=10.1002/ajh.21946|pmid=21351120}}</ref> Prognosis is generally good, and the survival rate of patients is usually normal with  regular medical supervision. However, the disease may rarely undergo a leukemic conversion or develop [[myelofibrosis]].   


==Natural history==
==Natural history==
The symptoms of essential thrombocytosis usually develop in two peaks, one in the third decade of life, and the other in the sixth decade of life. It may present with symptoms including but not limited to headache, dizziness, vision disturbances, chest pain, intense burning pain in hands and/or feet ([[erythromelalgia]]), numbness and tingling of hands and feet and [[priapism]] (persistent and painful erection of the penis). Without treatment, patients with very high counts will develop serious complications from vascular occlusion and/or bleeding. Rarely some cases progress to fatal leukemia or [[myelofibrosis]].  
The symptoms<ref name = paed/><ref>{{cite journal|last=Frewin|first=R|coauthors=Dowson, A|title=Headache in essential thrombocythaemia.|journal=International Journal of Clinical Practice|date=October 2012|volume=66|issue=10|pages=976-83|doi=10.1111/j.1742-1241.2012.02986.x|pmid=22889110|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469735/pdf/ijcp0066-0976.pdf|format=PDF|pmc=3469735}}</ref><ref>{{cite journal|last=Tefferi|first=A|title=Annual Clinical Updates in Hematological Malignancies: a continuing medical education series: polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk-stratification, and management.|journal=American Journal of Hematology|date=March 2011|volume=86|issue=3|pages=292-301|doi=10.1002/ajh.21946|pmid=21351120}}</ref> of essential thrombocytosis include but are not limited to headache, dizziness, vision disturbances, chest pain, intense burning pain in hands and/or feet ([[erythromelalgia]]), numbness and tingling of hands and feet and [[priapism]] (persistent and painful erection of the penis). Without treatment, patients with very high platelet counts will develop serious complications from vascular occlusion and/or bleeding. Rarely some cases progress to fatal leukemia or [[myelofibrosis]].  


==Complications==
==Complications==
*Some of the complications from essential thrombocytosis are as follows:
*Some of the complications from essential thrombocytosis are as follows<ref name = paed/><ref>{{cite journal|last=Frewin|first=R|coauthors=Dowson, A|title=Headache in essential thrombocythaemia.|journal=International Journal of Clinical Practice|date=October 2012|volume=66|issue=10|pages=976-83|doi=10.1111/j.1742-1241.2012.02986.x|pmid=22889110|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469735/pdf/ijcp0066-0976.pdf|format=PDF|pmc=3469735}}</ref><ref>{{cite journal|last=Tefferi|first=A|title=Annual Clinical Updates in Hematological Malignancies: a continuing medical education series: polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk-stratification, and management.|journal=American Journal of Hematology|date=March 2011|volume=86|issue=3|pages=292-301|doi=10.1002/ajh.21946|pmid=21351120}}</ref>:
**Thrombotic events  
**Thrombotic events  
***[[DVT]]
***[[DVT]]
Line 25: Line 25:
**Increased risk of thrombosis
**Increased risk of thrombosis
**Increased risk of spontaneous miscarriage
**Increased risk of spontaneous miscarriage
**IUGR
**[[IUGR]]
**Preterm labor
**Preterm labor
**Placental abruption
**[[Placental abruption]]


==Prognosis==
==Prognosis==

Revision as of 20:46, 16 November 2015

Essential thrombocytosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Epidemiology and Demographics

Risk Factors

Screening

Causes

Differentiating Essential thrombocytosis from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Essential thrombocytosis natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Essential thrombocytosis natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Essential thrombocytosis natural history, complications and prognosis

CDC on Essential thrombocytosis natural history, complications and prognosis

Essential thrombocytosis natural history, complications and prognosis in the news

Blogs on Essential thrombocytosis natural history, complications and prognosis

Directions to Hospitals Treating Essential thrombocytosis

Risk calculators and risk factors for Essential thrombocytosis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]

Overview

If left untreated, patients with essential thrombocytosis may progress to develop symptoms like headache, dizziness, vision disturbances, chest pain, intense burning pain in hands and/or feet (erythromelalgia), numbness and tingling of hands and feet, priapism (persistent and painful erection of the penis) and so on depending on the vessel occluded with the thrombus. Common complications of essential thrombocytosis include thrombotic events (DVT, cerebrovascular accidents,etc), bleeding (bruises, gum bleeds, epistaxis, etc), acute leukemia and myelofibrosis.[1][2][3] Prognosis is generally good, and the survival rate of patients is usually normal with regular medical supervision. However, the disease may rarely undergo a leukemic conversion or develop myelofibrosis.

Natural history

The symptoms[1][4][5] of essential thrombocytosis include but are not limited to headache, dizziness, vision disturbances, chest pain, intense burning pain in hands and/or feet (erythromelalgia), numbness and tingling of hands and feet and priapism (persistent and painful erection of the penis). Without treatment, patients with very high platelet counts will develop serious complications from vascular occlusion and/or bleeding. Rarely some cases progress to fatal leukemia or myelofibrosis.

Complications

  • Some of the complications from essential thrombocytosis are as follows[1][6][7]:
  • In predisposed individuals, gastrointestinal bleeding may sometimes worsen with aspirin where it is used to relieve symptoms of mild essential thrombocytosis. Hence it is contraindicated in these patients.[8]
  • Complications may occur in pregnant patients with essential thrombocytosis. High platelet counts cause placental infarction and places the fetus at a higher risk than the mother. The complications may include the following:

Prognosis

  • Essential thrombocytosis is associated with a good prognosis if medically supervised on a regular basis.
  • Most of the patients remain asymptomatic for a long time and are diagnosed on routine blood tests or when tested for other conditions. Although some patients with very high counts may present with severe hemorrhagic or thombotic events needing treatment.
  • Rarely the disease may progress to acute leukemia or myelofibrosis.

References

  1. ↑ 1.0 1.1 1.2
  2. ↑ Frewin, R (October 2012). "Headache in essential thrombocythaemia" (PDF). International Journal of Clinical Practice. 66 (10): 976–83. doi:10.1111/j.1742-1241.2012.02986.x. PMC 3469735. PMID 22889110. Unknown parameter |coauthors= ignored (help)
  3. ↑ Tefferi, A (March 2011). "Annual Clinical Updates in Hematological Malignancies: a continuing medical education series: polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk-stratification, and management". American Journal of Hematology. 86 (3): 292–301. doi:10.1002/ajh.21946. PMID 21351120.
  4. ↑ Frewin, R (October 2012). "Headache in essential thrombocythaemia" (PDF). International Journal of Clinical Practice. 66 (10): 976–83. doi:10.1111/j.1742-1241.2012.02986.x. PMC 3469735. PMID 22889110. Unknown parameter |coauthors= ignored (help)
  5. ↑ Tefferi, A (March 2011). "Annual Clinical Updates in Hematological Malignancies: a continuing medical education series: polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk-stratification, and management". American Journal of Hematology. 86 (3): 292–301. doi:10.1002/ajh.21946. PMID 21351120.
  6. ↑ Frewin, R (October 2012). "Headache in essential thrombocythaemia" (PDF). International Journal of Clinical Practice. 66 (10): 976–83. doi:10.1111/j.1742-1241.2012.02986.x. PMC 3469735. PMID 22889110. Unknown parameter |coauthors= ignored (help)
  7. ↑ Tefferi, A (March 2011). "Annual Clinical Updates in Hematological Malignancies: a continuing medical education series: polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk-stratification, and management". American Journal of Hematology. 86 (3): 292–301. doi:10.1002/ajh.21946. PMID 21351120.
  8. ↑ Brière JB (2007). "Essential thrombocythemia". Orphanet J Rare Dis. 2: 3. doi:10.1186/1750-1172-2-3. PMC 1781427. PMID 17210076.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Essential_thrombocytosis_natural_history,_complications_and_prognosis&oldid=1187775"