Abstract
Thrombocytosis represents a platelet count over 500.000/mm³. Objective. The aim of this study is to evaluate the frequency and gravity of reactive thrombocytosis in pediatric patients who underwent splenectomy. Material and method. We performed a retrospective study including 20 patients (4-16 years old) who underwent splenectomy between 2006-2015. The inclusion criteria in the study were: patients with the age under 18 years, who underwent splenectomy independently by the cause, and who developed afterwards thrombocytosis. Results. In the studied group 64% of the splenectomised patients (16) developed a form of thrombocytosis. In 4 cases – severe form (Platelets > 1 million/mm3) and in 7 cases a mild form. There were not noticed any significant differences regarding the gender repartition of the patients (9 were females, and 11 were males). In 13 patients, thrombocytosis disappeared after 30 days, and only in 3 cases, the episode lasted more than 360 days. Thrombotic phenomena were noticed only in one patient from our study group. All the patients benefited from thromboprophylaxis and hydration measures, and 2 cases needed associated treatment with Hydroxyurea. Conclusions. Our study reveals an increased frequency of thrombocytosis after splenectomy (80%), with a maximum peak of incidence in 2-10 days following the intervention, thrombocytosis being generally benign and self-limited; still one of the cases experienced thrombotic complications and severe thrombocytosis was more frequent after post-traumatic splenectomy.
Highlights
Spleen is a complex lymphoid organ that besides the hematopoietic functions, fulfills other important roles such as the immunologic one, mechanical blood filtration or as cellular reservoir
Postsplenectomy syndrome is characterized by a group of possible complications following the intervention such as: infections, anemia caused by red cell destruction, thrombocytosis [1]
Thrombocytosis is defined by a platelet count > 500.000/mm3 and is frequently encountered as an incidental laboratory finding
Summary
Spleen is a complex lymphoid organ that besides the hematopoietic functions, fulfills other important roles such as the immunologic one, mechanical blood filtration or as cellular reservoir. Thrombocytosis is defined by a platelet count > 500.000/mm and is frequently encountered as an incidental laboratory finding It can be either primary (clonal) – when it is attributed to a myeloproliferative disorder with abnormal transformation of the hematopoietic cell; it often complicates with thromboembolic phenomena [2]. Reactive thrombocytosis is secondary to other conditions such as infections, inflammation, trauma, malignancy, or due to splenectomy [3,4] It is a benign and self-limiting disorder which rarely degenerates in massive hemorrhages or thrombotic phenomena (4-6% of the cases); complications of these type may be due mostly to some qualitative abnormalities of the platelets, and not to quantitative ones [5,6]
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