Essential thrombocytosis laboratory findings

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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

Laboratory findings consistent with the diagnosis of essential thrombocytosis include abnormal complete blood count (CBC), elevated platelet count, peripheral blood smear showing large platelets, megakaryocyte fragments and platelet aggregates, presence of JAK2 mutation and absence of BCR-ABL or Philadelphia chromosome.[1] Leukocytosis, erythrocytosis, and mild anemia may be present. Bone marrow biopsy is an important test and needed to make a diagnosis of essential thrombocytosis as per WHO definition[2].

Laboratory findings

Essential thrombocytosis remains a diagnosis of exclusion that needs to rule out reactive or secondary causes of thrombocytosis . Laboratory tests for the diagnosis of essential thrombocytosis include the following[3]:

  • Complete blood count (CBC)
  • Peripheral blood smear shows large platelets, megakaryocyte fragments and platelet aggregates[4]
  • To rule out inflammatory disorders
  • To rule out iron deficiency and polycythemia vera
  • To rule out other myeloproliferative neoplasms
    • BCR-ABL or Philadelphia chromosome
  • Genetic studies
    • JAK2 mutation using PCR

References

  1. Essential Thrombocythemia. Merck manual. http://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/essential-thrombocythemia. Accessed on November 11,2015.
  2. 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).
  3. Essential Thrombocytosis Workup. Medscape. http://emedicine.medscape.com/article/206697-workup#c8. Accessed on November 10th, 2015
  4. Essential Thrombocythemia. Merck manual. http://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/essential-thrombocythemia. Accessed on November 11,2015.


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