Nadpłytkowości pierwotne i wtórne u dzieci

Abstract

BackgroundThrombocytosis is defined as increased number of peripheral blood platelets. With respect to this value, it is graded as: mild thrombocytosis with platelet number 500–700 G/L; moderate thrombocytosis with platelet number 700–900 G/L; severe thrombocytosis with platelet number >900 G/L and extreme thrombocytosis if the platelet count is >1000 G/L. ObjectiveAnalysis of epidemiology, etiology and clinical course of essential and reactive thrombocytoses in children. MethodsAll consecutive children hospitalized in pediatric, hematology and oncology ward during 48 months were potential subjects of this retrospective analysis. All children with at least one platelet count above 500 G/L were included into the study. ResultsThrombocytosis was observed in 628/12910 (4.86%) hospitalizations. It was diagnosed as mild in 83.9% of cases; moderate and severe in 14.0%, and extreme in 2.1% cases. The most frequent cause of thrombocytosis was infections and iron deficiency anemia, as well as bone marrow regeneration after chemotherapy administered due to malignancy and patients after splenectomy. It was found that essential thrombocythemia is a very rare disease in children and constitutes only 0.47% off all cases of thrombocytosis, and 0.02% of all hospitalizations in pediatric, hematology and oncology ward. Clinical course of reactive thrombocytosis is usually symptomless with fast normalization of platelet count after underlying condition has been cured. ConclusionsSecondary thrombocytosis occurs in nearly 5% of hospitalized children, while essential thrombocythemia is a very rare disease of childhood. There are no recommendations for routine prophylaxis with thrombolytic agents or inhibitors of platelet aggregation in secondary thrombocytosis.