Thrombocytosis differential diagnosis

	Thrombocytosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Thrombocytosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
CT
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Thrombocytosis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Thrombocytosis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Thrombocytosis differential diagnosis
CDC on Thrombocytosis differential diagnosis
Thrombocytosis differential diagnosis in the news
Blogs on Thrombocytosis differential diagnosis
Directions to Hospitals Treating Thrombocytosis
Risk calculators and risk factors for Thrombocytosis differential diagnosis

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				Para−clinical findings
											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					Fever	Appearance	Bleeding	BP	Splenomegaly	Jaundice	Other	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT
Autonomous thrombocytosis	Hematologic malignancies	Essential thrombocythemia^[1]	Acquired mutation of JAK2, CALR, or MPL	+	-	-	-	+	Mean age >60 years old, female > male	Vascular occlusive events and hemorrhages	±	Flushing	+	Nl	+	-	Erythromelalgia Transient ischemic attacks Priapism Decreased visual acuity	↑↑	↑	↑	Large platelets Megakaryocyte fragments Platelet aggregates	Increased cellularity Hyperplasia and clustering of megakaryocytes Bone marrow reticulin may be increased with no collagen fibrosis	Nl	Nl	Splenomegaly on abdominal CT VTE on spiral chest CT DVT on ultrasound	Bone marrow biopsy	Thrombo-hemorrhagic complications
		Polycythemia vera^[2]	Acquired mutation of JAK2	+	-	-	-	+	Mean age >60 years old		-	Facial plethora	±	Nl	+	-	Erythromelalgia Pruritus Tinnitus Blurred vision Lymphadenopathy	↑	↑↑	↑	Panmyelosis including prominent erythroid, granulocyte, and megakaryocyte proliferation	Panmyelosis including prominent erythroid, granulocyte, and megakaryocyte proliferation Pleomorphic, mature megakaryocytes	↑	↑		Bone marrow biopsy	Thrombo-hemorrhagic complications
		Primary myelofibrosis^[3]	Bone marrow fibrosis Mutation in JAK2, CALR, or MPL	+	-	-	-	+	Mean age >60 years old, male> female		-	Pallor Bruising Skin nodules	+	Nl	+	+	Fatigue Abdominal pain Early satiety Dyspnea Lymphadenopathy	↑/↓	↓	↓	Decreased number of erythroid, granulocyte, and megakaryocyte proliferation	Proliferation and atypia of megakaryocytes Reticulin or collagen fibrosis Hypercellular bone marrow	↑	↑	Diffuse bone sclerosis on CT	Bone marrow biopsy	Thrombo-hemorrhagic complications Variable risk for development of acute leukemia
		Chronic myeloid leukemia^[4]	Translocation (9;22), the Philadelphia chromosome BCR-ABL1 oncogene	+	-	-	-	+	Mean age >50 years old, male> female		+	Pallor Bruises Petechiae Ulcers Vesicles	+	Nl	+	-	Fatigue Abdominal pain Early satiety Dyspnea Lymphadenopathy	↑	↓	↑	Immature leukocytes Leukemic blasts Leukoerythroblastic features Giant platelets Blast crisis	↑ Proportion of metamyelocytes and other white blood cells at various stages of maturation	↑	↑	Enlarged lymph nodes and splenomegaly on CT scan	Bone marrow biopsy	Increase of immature myeloid cells
		Acute myeloid leukemia^[5]	Unknown	+	-	-	-	+	Median age of 63 years old	History of hematological disorder History of chemotherapy and ionizing radiation	+	Pallor Leukemia cutis Bruising Petechiae Ecchymosis	+	Nl	+	+	Fatigue Bone tenderness Early satiety	↑/↓	↓	↑/↓	Leukemic blasts Leukoerythroblastic features Giant platelets	"Dry tap" on aspiration Leukemic cells	↑	↑	NA	Bone marrow examination + clinical manifestation	Infections of variable severity Cranial nerve palsy
		Myelodysplastic syndromes^[6]	Unknown Mutation	+	-	-	-/+	+	Elderly	Exposure to Chemotherapy Radiation therapy Tobacco smoke	+/-	Petechiae, purpura, diffuse erythematous rash	+	Nl	+	+	Shortness of breath Fatigue	↑/↓	↓	↓	Large platelets Ovalomacrocytosis Basophilic stippling Howell-Jolly body Pelger-Huet anomaly Ring sideroblasts	Impaired myeloid maturation Dyserythropoiesis Dysgranulopoiesis Dysmegakaryocytopoiesis Hypercellular bone marrow Fibrosis	Nl	Nl	NA	Bone marrow examination + clinical manifestation	Thrombosis at unusual sites Thrombosis in younger patients Might transformed to acute leukemia
	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		Mutation in TPO and MPL	+	-	-	+	-										↑	Nl	Nl	Giant platelets Platelet conglomerates Bizarre forms Megakaryocytic fragments Platelet hypogranularity						Mendelian inheritance High penetrance Polyclonal hematopoiesis
Reactive thrombocytosis	Anemia/ blood loss	Iron deficiency Blood loss Hemolysis		+						History of bleeding or iron deficiency								↑	↓								Required iron studies
	Infection	Chronic infections		+	+													↑		↑
		Tuberculosis		+	+													↑		↑
		Acute bacterial and viral infections		+	+													↑		↑
	Inflammation	Vasculitides		+	+													↑		↑
		Acute pancreatitis		+	+													↑		↑
		Malignancy		+	+													↑		↑
	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																↑
		Trauma																↑
		Myocardial infarction																↑
	Medication	Myelosuppressive agents																↑
		Vincristine																↑
		Epinephrine, glucocorticoids																↑
		Interleukin-1B																↑
		All-trans retinoic acid																↑
		Thrombopoietin																↑
	Other	Post-splenectomy or functional asplenia				+				Prior surgical removal of the spleen Sickle cell disease								↑			Howell-Jolly bodies Nucleated RBCs
		Allergic reactions																↑
		Exercise																↑
	Pseudothrombocytosis	Mixed cryoglobulinemia
	Pseudothrombocytosis	Cytoplasmic fragments
Category	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

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 |title= (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.

[Brière2007-1] 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 |title= (help)

[ArberOrazi2016-2] 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.

[TefferiLasho2012-3] 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.

[ThompsonKantarjian2015-4] 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-InmanKuehl2014-5] 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.

[NatelsonPyatt2013-6] 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.

[1]

[2]

[3]

[4]

[5]

[6]

Thrombocytosis differential diagnosis

Overview

Thrombocytosis Differential Diagnosis

References

Navigation menu