Approach to a patient with reactive thrombocythemia

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.

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