Definition
Persistent significant increase in platelet count >450×109/L. Reactive causes are much more common than myeloproliferative neoplasms (MPNs).
Primary causes may be suspected if there is an associated erythrocytosis or leucocytosis. Complications of MPNs include arterial or venous occlusive events.
Causes of a reactive thrombocytosis include: infection; inflammation; iron deficiency and/or bleeding; recent surgery; hyposplenism; solid organ malignancy.
If malignancy is suspected, please follow the recommendations of the Scottish Referral Guidelines for Suspected Cancer opens a new window. The referral section opens a new window (2.2.7) highlights that:
“Recent evidence has identified thrombocytosis as a strong risk marker for malignancy, in particular lung, endometrial, gastric, oesophageal and colorectal cancer (acronym “LEGO-C”). With a cancer incidence of 11.6% and 6.2% in males and females respectively, these figures well exceed the 3% threshold to warrant investigation”.
Please consider an Urgent Suspicion of Cancer Chest-Xray for those with a thrombocytosis where symptoms and signs do not suggest another specific cancer: https://www.cancerreferral.scot.nhs.uk/lung-cancer/?alttemplate=guideline opens a new window
C.M & L.W 26-03-24
