Approach to a patient with reactive thrombocythemia

2018-06-14

Mark Crowther

What is your approach to reactive thrombocythemia? Do you use anticoagulants or aspirin?

Mark Crowther: I do not. The highest platelet count that we have seen that was ultimately found to be reactive in our institution was 3.5 million/µL. We did not do anything in that person except find the source of the secondary stimulus, which was an empyema.

If we believe that it is reactive, I do not think that there is a role for cytoreduction. I might put the person on aspirin while we figure out what the source of the inflammatory state is and deal with it. If it is truly secondary, it will be reduced once you get on to treating the primary cause.

See also

Antithrombotic therapies: current patterns of practice and controversies A lecture by Dr Mark Crowther, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.
Anticoagulation following an episode of severe bleeding What patients should not be restarted on anticoagulation therapy following an episode of severe bleeding?
Balancing the risk of recurrent VTE and the bleeding risk from anticoagulation How can we balance the risk of recurrent venous thromboembolism following an episode of unprovoked VTE and the increased bleeding risk associated with continued anticoagulation?
Perioperative anticoagulation: reconciling different views In Poland, surgeons and internists often have different approaches to perioperative anticoagulation. What would be your advice for a physician who struggles to find a middle ground between the expectations of a surgeon and an internist?
History of proximal thrombosis and pregnancy Should female patients with a history of proximal thrombosis (affecting iliac vein or inferior vena cava) plan to become pregnant? What should be our recommendation for such patients? Does lack of recanalization of the affected vein pose additional problems?
Approach to a patient with anemia Prof. Mark Crowther, from McMaster University, Canada, discusses how to approach a patient with anemia. The lecture uses practical case examples to highlight the importance of correct diagnosis and choosing effective therapy.

Approach to a patient with reactive thrombocythemia

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