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==Overview==
==Overview==
ET is a diagnosis of exclusion
Lab tests for the diagnosis of Essential thrombocytosis include tests to rule out reactive or secondary causes of thrombocytosis and ET remains a diagnosis of exclusion. The tests include abnormal complete blood count (CBC), peripheral blood smear, cytogenetic studies including Philadelphia chromosome or BCR-ABL assay, and the presence of ''JAK2 V617F'' mutations. Bone marrow biopsy is an important test and needed to make a diagnosis of ET.<ref name="pmidhttp://dx.doi.org/10.1182/blood-2007-04-083501">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=http://dx.doi.org/10.1182/blood-2007-04-083501 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref>
==Diagnostic criteria==
 
The diagnosis of essential thrombocytosis requires the presence of a persistent thrombocytosis of greater than 600 x10<sup>9</sup>/L in the absence of an alternative cause.
 
==Laboratory findings==
Lab tests for the diagnosis of Essential thrombocytosis include the following<ref>Essential Thrombocytosis Workup. Medscape. http://emedicine.medscape.com/article/206697-workup#c8. Accessed on November 10th, 2015</ref>:
*Complete blood count ([[CBC]])
**Elevated platelet count
**Leukocytosis, erythrocytosis, and mild anemia may be present
*Peripheral blood smear shows large platelets
*Platelet aggregation studies may be abnormal in some patients


The following revised diagnostic criteria for essential thrombocytosis were proposed in 2005 <ref name=Campbell>Campbell PJ, Green AR. ''Management of Polycythemia Vera and Essential Thrombocythemia.'' Hematology (Am Soc Hematol Educ Program). 2005;:201-8. PMID 16304381</ref>. The diagnosis requires the presence of both A criteria together with B3 to B6, or of criterion A1 together with B1 to B6.


* A1. Platelet count > 600 x 10<sup>9</sup>/L for at least 2 months
* A2. Acquired V617F JAK2 mutation present
* B1. No cause for a reactive thrombocytosis
** normal inflammatory indices
* B2. No evidence of iron deficiency
** stainable iron in the bone marrow or normal red cell mean corpuscular volume
* B3. No evidence of [[polycythemia vera]]
** hematocrit < midpoint of normal range or normal red cell mass in presence of normal iron stores
* B4. No evidence of chronic myeloid leukemia
But the Philadelphia chromosome may be present in up to 10% of cases. Patients withe the Philadelphia chromosome have a potential for the development of acute leukemia, especially acute lymphocytic leukemia.
* B5. No evidence of [[myelofibrosis]]
** no collagen fibrosis and ≤ grade 2 reticulin fibrosis (using 0–4 scale)
* B6. No evidence of a myelodysplastic syndrome
** no significant dysplasia
** no cytogenetic abnormalities suggestive of myelodysplasia


==References==
==References==

Revision as of 02:09, 11 November 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Lab tests for the diagnosis of Essential thrombocytosis include tests to rule out reactive or secondary causes of thrombocytosis and ET remains a diagnosis of exclusion. The tests include abnormal complete blood count (CBC), peripheral blood smear, cytogenetic studies including Philadelphia chromosome or BCR-ABL assay, and the presence of JAK2 V617F mutations. Bone marrow biopsy is an important test and needed to make a diagnosis of ET.[1]


Laboratory findings

Lab tests for the diagnosis of Essential thrombocytosis include the following[2]:

  • Complete blood count (CBC)
    • Elevated platelet count
    • Leukocytosis, erythrocytosis, and mild anemia may be present
  • Peripheral blood smear shows large platelets
  • Platelet aggregation studies may be abnormal in some patients


References

  1. ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID http://dx.doi.org/10.1182/blood-2007-04-083501 Check |pmid= value (help).
  2. ↑ Essential Thrombocytosis Workup. Medscape. http://emedicine.medscape.com/article/206697-workup#c8. Accessed on November 10th, 2015


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