Thrombocytosis differential diagnosis: Difference between revisions
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* History of hematological disorder | * History of [[hematological]] disorder | ||
* History of [[chemotherapy]] and [[ionizing radiation]] | * History of [[chemotherapy]] and [[ionizing radiation]] | ||
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* Leukemic blasts | * [[Leukemic]] blasts | ||
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* [[Petechia|Petechiae]] | * [[Petechia|Petechiae]] | ||
* [[Purpura]] | * [[Purpura]] |
Revision as of 16:08, 2 October 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Thrombocytosis Differential Diagnosis
Differentiating the diseases that can cause thrombocytosis :
Category | Condition | Etiology | Mechanism | Inherited | Acquried | Clinical manifestations | Para−clinical findings | Gold standard | Associated findings | ||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Demography | History | Symptoms | Signs | ||||||||||||||||||||||||
Lab Findings | Imaging | ||||||||||||||||||||||||||
Fever | Appearance | Bleeding | BP | Splenomegaly | Jaundice | Other | CBC | PBS | Bone marrow exam | PT | PTT | ||||||||||||||||
Increased megakaryocyte proliferation | Accelerated platelet release | Reduced platelet turnover | Plt | HB | WBC | ||||||||||||||||||||||
Autonomous thrombocytosis | Hematologic malignancies | Essential thrombocythemia[1] |
|
+ | - | - | - | + | Mean age >60 years old, female > male |
|
± |
|
+ | Nl | + | - | ↑↑ | ↑ | ↑ |
|
|
Nl | Nl |
|
Bone marrow biopsy |
| |
Polycythemia vera[2] |
|
+ | - | - | - | + | Mean age >60 years old |
|
- |
|
± | Nl | + | - | ↑ | ↑↑ | ↑ |
|
|
↑ | ↑ | Bone marrow biopsy |
| ||||
Primary myelofibrosis[3] |
|
+ | - | - | - | + | Mean age >60 years old, male> female |
|
- | + | Nl | + | + |
|
↑/↓ | ↓ | ↓ |
|
|
↑ | ↑ | Bone marrow biopsy |
| ||||
Chronic myeloid leukemia[4] |
|
+ | - | - | - | + | Mean age >50 years old, male> female | History of exposure to: | + | + | Nl | + | - |
|
↑ | ↓ | ↑ |
|
|
↑ | ↑ |
|
Bone marrow biopsy |
| |||
Acute myeloid leukemia[5] |
|
+ | - | - | - | + | Median age of 63 years old |
|
+ | + | Nl | + | + |
|
↑/↓ | ↓ | ↑/↓ |
|
↑ | ↑ | NA | Bone marrow examination + clinical manifestation |
| ||||
Myelodysplastic syndromes[6] |
|
+ | - | - | ± | + | Elderly | Exposure to | ± | + | Nl | + | + | ↑/↓ | ↓ | ↓ |
|
|
Nl | Nl | NA | Bone marrow examination + clinical manifestation |
| ||||
Condition | Etiology | Increased megakaryocyte proliferation | Accelerated platelet release | Reduced platelet turnover | Inherited | Acquried | Demography | History | Fever | Appearance | Bleeding | BP | Splenomegaly | Jaundice | Other signs | Plt | HB | WBC | PBS | Bone marrow exam | PT | PTT | Imaging | Gold standard | Associated findings | ||
Familial thrombocytosis[7][8] |
|
+ | - | - | + | - | Rare familial disease, middle age male and female |
|
- |
|
- | Nl | - | - | - | ↑ | Nl | Nl |
|
|
Nl | Nl | NA | Genetic study |
| ||
Reactive thrombocytosis | Anemia/ |
|
+ | - | - | - | + | Any |
|
- | + | Nl to ↓ | - | - | Depends on the etilogy | ↑ | ↓ | Nl |
|
|
Nl | Nl | NA | Clinical manifestation |
| ||
Infection | Chronic infections |
|
+ | + | - | - | + | Any |
|
+ | ± | Nl to ↓ | - | ± | Depends on the etilogy | ↑ | ↓ | ↑ |
|
|
Nl | Nl |
|
Culture | Depends on the etilogy | ||
Tuberculosis |
|
+ | + | - | - | + | Any |
|
+ |
|
- | Nl | - | - | ↑ | Nl | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation+ culture | ||||
Acute bacterial and viral infections |
|
+ | + | - | - | + | Any |
|
+ |
|
- | Nl | - | - | Depends on the etilogy | ↑ | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation+ culture |
| |||
Inflammation | Vasculitides[10] |
|
+ | + | - | ± | + | Any |
|
+ |
|
+ | Nl | - | - | ↑ | Nl to ↓ | ↑ |
|
|
Nl to ↑ | Nl to ↑ |
|
Clinical manifestation+ culture |
| ||
Acute pancreatitis |
|
+ | + | - | - | + | Any | + |
|
- | Nl to ↓ | - | + | ↑ | Nl to ↓ | ↑ |
|
|
Nl to ↑ | Nl to ↑ |
|
Clinical manifestation |
| ||||
Malignancy[11] |
|
+ | + | - | ± | ± | Any |
|
+ |
|
- | Nl to ↓ | Depends on the type | - |
|
↑ | Nl to ↓ | ↑ |
|
|
Nl to ↑ | Nl to ↑ |
|
Biopsy |
| ||
Condition | Etiology | Increased megakaryocyte proliferation | Accelerated platelet release | Reduced platelet turnover | Inherited | Acquried | Demography | History | Fever | Appearance | Bleeding | BP | Splenomegaly | Jaundice | Other signs | Plt | HB | WBC | PBS | Bone marrow exam | PT | PTT | Imaging | Gold standard | Associated findings | ||
Tissue damage | Thermal burns[12] |
|
- | + | - | - | + | Any |
|
+ |
|
± | Nl to ↓ | - | ± | ↑ | Nl to ↓ | ↑ |
|
|
Nl to ↑ | Nl to ↑ |
|
Clinical manifestation | |||
Trauma[13] |
|
- | + | - | - | + | Any |
|
± |
|
± | Nl to ↓ | - | - | ↑ | Nl to ↓ | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation |
| |||
Myocardial infarction[14] |
|
- | + | - | - | + | Elderly | ± |
|
- | Nl to ↓ | - | - | ↑ | Nl to ↓ | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation + enzymes elevation |
| ||||
Medication[15] | Vincristine[16] |
|
- | + | - | - | + | Any |
|
- |
|
- | Nl | + | - | ↑ | Nl to ↓ | ↑ |
|
|
Nl to ↑ | Nl to ↑ |
|
Clinical manifestation + history of drug consumption | |||
Epinephrine[17] |
|
+ | + | - | - | + | Any |
|
- |
|
- | Nl to ↓ | - | - | ↑ | ↑ | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation + history of drug consumption |
| |||
Glucocorticoids[18] |
|
+ | + | - | - | + | Any | + |
|
Nl to ↓ | - | - | ↑ | Nl to ↓ | ↑ |
|
|
Nl to ↑ | Nl to ↑ |
|
Clinical manifestation + history of drug consumption |
| |||||
Antibiotics[19] |
|
+ | + | - | - | + | Any | + | Nl | ± | Nl | - | - |
|
↑ | Nl | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation + history of drug consumption |
| |||
Thrombopoietin[20][21] |
|
+ | - | - | - | + | Any | + |
|
- | Nl to ↑ | - | - |
|
↑ | ↑ | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation + history of drug consumption |
| |||
Condition | Etiology | Increased megakaryocyte proliferation | Accelerated platelet release | Reduced platelet turnover | Inherited | Acquried | Demography | History | Fever | Appearance | Bleeding | BP | Splenomegaly | Jaundice | Other signs | Plt | HB | WBC | PBS | Bone marrow exam | PT | PTT | Imaging | Gold standard | Associated findings | ||
Other | Post-splenectomy or functional asplenia[22] |
|
- | - | + | - | + | Any |
|
± |
|
+ | Nl | Asplenia | - | - | ↑ | ↓ | ↑ |
|
|
Nl | Nl | Clinical manifestation |
| ||
Allergic reactions[23] |
|
+ | + | - | - | + | Any |
|
- |
|
- | Nl to ↓ | - | - | ↑ | ↑ | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation |
| |||
Exercise[24] |
|
+ | + | - | - | + | Athlete |
|
- | Normal | - | Nl | - | - | NA | ↑ | ↑ | ↑ |
|
|
Nl | Nl |
|
Clinical manifestation | NA | ||
Pseudothrombocytosis | Mixed cryoglobulinemia[25] |
|
- | - | - | - | - | Any | - |
|
- | Nl | - | - |
|
↑ | Nl to ↓ | ↑ |
|
Nl | Nl | Nl | NA | Skin biopsy | |||
Cytoplasmic fragments[26] |
|
- | - | - | - | - | Any | NA | - | Normal | - | Nl | - | - | NA | ↑ | Nl | Nl |
|
Nl | Nl | Nl | Nl | Repeat | NA |
References
- ↑ Brière, Jean B (2007). Orphanet Journal of Rare Diseases. 2 (1): 3. doi:10.1186/1750-1172-2-3. ISSN 1750-1172. Missing or empty
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(help) - ↑ Arber, D. A.; Orazi, A.; Hasserjian, R.; Thiele, J.; Borowitz, M. J.; Le Beau, M. M.; Bloomfield, C. D.; Cazzola, M.; Vardiman, J. W. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–2405. doi:10.1182/blood-2016-03-643544. ISSN 0006-4971.
- ↑ Tefferi, Ayalew; Lasho, Terra L.; Jimma, Thitina; Finke, Christy M.; Gangat, Naseema; Vaidya, Rakhee; Begna, Kebede H.; Al-Kali, Aref; Ketterling, Rhett P.; Hanson, Curtis A.; Pardanani, Animesh (2012). "One Thousand Patients With Primary Myelofibrosis: The Mayo Clinic Experience". Mayo Clinic Proceedings. 87 (1): 25–33. doi:10.1016/j.mayocp.2011.11.001. ISSN 0025-6196.
- ↑ Thompson, Philip A.; Kantarjian, Hagop M.; Cortes, Jorge E. (2015). "Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015". Mayo Clinic Proceedings. 90 (10): 1440–1454. doi:10.1016/j.mayocp.2015.08.010. ISSN 0025-6196.
- ↑ Rose-Inman, Hayley; Kuehl, Damon (2014). "Acute Leukemia". Emergency Medicine Clinics of North America. 32 (3): 579–596. doi:10.1016/j.emc.2014.04.004. ISSN 0733-8627.
- ↑ Natelson, Ethan A.; Pyatt, David (2013). "Acquired Myelodysplasia or Myelodysplastic Syndrome: Clearing the Fog". Advances in Hematology. 2013: 1–11. doi:10.1155/2013/309637. ISSN 1687-9104.
- ↑ Ding, J. (2004). "Familial essential thrombocythemia associated with a dominant-positive activating mutation of the c-MPL gene, which encodes for the receptor for thrombopoietin". Blood. 103 (11): 4198–4200. doi:10.1182/blood-2003-10-3471. ISSN 0006-4971.
- ↑ Wiestner, A.; Padosch, S. A.; Ghilardi, N.; Cesar, J. M.; Odriozola, J.; Shapiro, A.; Skoda, R. C. (2000). "Hereditary thrombocythaemia is a genetically heterogeneous disorder: exclusion of TPO and MPL in two families with hereditary thrombocythaemia". British Journal of Haematology. 110 (1): 104–109. doi:10.1046/j.1365-2141.2000.02169.x. ISSN 0007-1048.
- ↑ Kuter, David J. (1996). "The Physiology of Platelet Production". Stem Cells. 14 (S1): 88–101. doi:10.1002/stem.5530140711. ISSN 1066-5099.
- ↑ Hamblin T, Oscier D (September 1978). "Polyarteritis presenting with thrombocytosis and palliated by plasma exchange". Postgrad Med J. 54 (635): 615–7. PMC 2425233. PMID 82963.
- ↑ Yang, Chen; Jiang, Hui; Huang, Shaozhuo; Hong, Hui; Huang, Xiaowen; Wang, Xiaojie; Liao, Weixin; Wang, Xueyi; Chen, Xuewen; Jiang, Liming (2018). "The prognostic role of pretreatment thrombocytosis in gastric cancer". Medicine. 97 (31): e11763. doi:10.1097/MD.0000000000011763. ISSN 0025-7974.
- ↑ Dinsdale, R. J.; Devi, A.; Hampson, P.; Wearn, C. M.; Bamford, A. L.; Hazeldine, J.; Bishop, J.; Ahmed, S.; Watson, C.; Lord, J. M.; Moiemen, N.; Harrison, P. (2017). "Changes in novel haematological parameters following thermal injury: A prospective observational cohort study". Scientific Reports. 7 (1). doi:10.1038/s41598-017-03222-w. ISSN 2045-2322.
- ↑ Salim, Ali; Hadjizacharia, Pantelis; DuBose, Joseph; Kobayashi, Leslie; Inaba, Kenji; Chan, Linda S.; Margulies, Daniel R. (2009). "What is the Significance of Thrombocytosis in Patients With Trauma?". The Journal of Trauma: Injury, Infection, and Critical Care. 66 (5): 1349–1354. doi:10.1097/TA.0b013e318191b8af. ISSN 0022-5282.
- ↑ Frye JL, Thompson DF (February 1993). "Drug-induced thrombocytosis". J Clin Pharm Ther. 18 (1): 45–8. PMID 8473359.
- ↑ Feliu, E.; Cervantes, F.; Blade, J.; Rozman, C. (1980). "Thrombocytosis in Quiescent Chronic Granulocytic Leukaemia after Vincristine and 6-Mercaptopurine Therapy". Acta Haematologica. 64 (4): 224–226. doi:10.1159/000207258. ISSN 0001-5792.
- ↑ Spalding A, Vaitkevicius H, Dill S, MacKenzie S, Schmaier A, Lockette W (February 1998). "Mechanism of epinephrine-induced platelet aggregation". Hypertension. 31 (2): 603–7. PMID 9461228.
- ↑ Neel, Jennifer A.; Snyder, Laura; Grindem, Carol B. (2012). "Thrombocytosis: a retrospective study of 165 dogs". Veterinary Clinical Pathology. 41 (2): 216–222. doi:10.1111/j.1939-165X.2012.00416.x. ISSN 0275-6382.
- ↑ Scharf RE (November 2012). "Drugs that affect platelet function". Semin. Thromb. Hemost. 38 (8): 865–83. doi:10.1055/s-0032-1328881. PMID 23111864.
- ↑ Hitchcock IS, Kaushansky K (April 2014). "Thrombopoietin from beginning to end". Br. J. Haematol. 165 (2): 259–68. doi:10.1111/bjh.12772. PMID 24499199.
- ↑ Teofili, Luciana; Giona, Fiorina; Martini, Maurizio; Torti, Lorenza; Cenci, Tonia; Foà, Robin; Leone, Giuseppe; Larocca, Luigi M. (2010). "Thrombopoietin Receptor Activation, Thrombopoietin Mimetic Drugs, and Hereditary Thrombocytosis: Remarks on Bone Marrow Fibrosis". Journal of Clinical Oncology. 28 (19): e317–e318. doi:10.1200/JCO.2010.29.0387. ISSN 0732-183X.
- ↑ Vlachaki E, Kalogeridis A, Neokleous N, Perifanis V, Klonizakis F, Ioannidou E, Klonizakis I (May 2012). "Absence of JAK2V617F mutation in patients with beta-thalassemia major and thrombocytosis due to splenectomy". Mol. Biol. Rep. 39 (5): 6101–5. doi:10.1007/s11033-011-1425-7. PMID 22203487.
- ↑ Randi ML, Rossi C, Fabris F, Zerbinati P, Girolami A (December 1995). "Atopic dermatitis and allergic diseases with thrombocytosis: a possible link". Ann. Allergy Asthma Immunol. 75 (6 Pt 1): 530–2. PMID 8603285.
- ↑ Beck WR, Scariot PP, Gobatto CA (2014). "Primary and secondary thrombocytosis induced by exercise and environmental luminosity". Bratisl Lek Listy. 115 (10): 607–10. PMID 25573725.
- ↑ Patel KJ, Hughes CG, Parapia LA (January 1987). "Pseudoleucocytosis and pseudothrombocytosis due to cryoglobulinaemia". J. Clin. Pathol. 40 (1): 120–1. PMC 1140844. PMID 3818970.
- ↑ Akinci, Sema; Hacibekiroglu, Tuba; Basturk, Abdulkadir; Bakanay, Sule Mine; Guney, Tekin; Dilek, Imdat (2013). "Pseudothrombocytosis due to Microerythrocytosis: A Case of Beta Thalassemia Minor Complicated with Iron Deficiency Anemia". Acta Haematologica. 130 (2): 61–63. doi:10.1159/000346434. ISSN 1421-9662.