Essential thrombocytosis natural history, complications and prognosis: Difference between revisions
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**[[Myelofibrosis]] | **[[Myelofibrosis]] | ||
*In predisposed individuals, gastrointestinal bleeding may sometimes worsen with [[aspirin]] where it is used to relieve symptoms of mild ET. Hence it is contraindicated in these patients.<ref name="pmid17210076">{{cite journal| author=Brière JB| title=Essential thrombocythemia. | journal=Orphanet J Rare Dis | year= 2007 | volume= 2 | issue= | pages= 3 | pmid=17210076 | doi=10.1186/1750-1172-2-3 | pmc=PMC1781427 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17210076 }} </ref> | *In predisposed individuals, gastrointestinal bleeding may sometimes worsen with [[aspirin]] where it is used to relieve symptoms of mild ET. Hence it is contraindicated in these patients.<ref name="pmid17210076">{{cite journal| author=Brière JB| title=Essential thrombocythemia. | journal=Orphanet J Rare Dis | year= 2007 | volume= 2 | issue= | pages= 3 | pmid=17210076 | doi=10.1186/1750-1172-2-3 | pmc=PMC1781427 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17210076 }} </ref> | ||
*Complications may occur in pregnant ET patients. High platelet counts cause placental | *Complications may occur in pregnant ET patients. High platelet counts cause placental infarction and places the fetus at a higher risk than the mother. The complications may include the following: | ||
**Increased risk of thrombosis | **Increased risk of thrombosis | ||
**Increased risk of spontaneous miscarriage | **Increased risk of spontaneous miscarriage | ||
Revision as of 20:15, 11 November 2015
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Essential thrombocytosis Microchapters |
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Differentiating Essential thrombocytosis from other Diseases |
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Diagnosis |
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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. 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.
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.
Complications
- Some of the complications from essential thrombocytosis are as follows:
- Thrombotic events
- DVT
- Cerebrovascular accidents (CVA)
- Myocardial infarction
- Bleeding
- Bruises
- Gum bleeds
- Epistaxis
- Acute leukemia
- Myelofibrosis
- Thrombotic events
- In predisposed individuals, gastrointestinal bleeding may sometimes worsen with aspirin where it is used to relieve symptoms of mild ET. Hence it is contraindicated in these patients.[1]
- Complications may occur in pregnant ET patients. High platelet counts cause placental infarction and places the fetus at a higher risk than the mother. The complications may include the following:
- Increased risk of thrombosis
- Increased risk of spontaneous miscarriage
- IUGR
- Preterm labor
- Placental abruption
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
- ↑ Brière JB (2007). "Essential thrombocythemia". Orphanet J Rare Dis. 2: 3. doi:10.1186/1750-1172-2-3. PMC 1781427. PMID 17210076.